Provider Demographics
NPI:1841496619
Name:MAES, ANDREW ARTHUR (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ARTHUR
Last Name:MAES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:122 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5794
Mailing Address - Country:US
Mailing Address - Phone:920-996-3264
Mailing Address - Fax:920-830-5970
Practice Address - Street 1:225 MEMORIAL DR STE 2010
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:WI
Practice Address - Zip Code:54923-1243
Practice Address - Country:US
Practice Address - Phone:920-361-5975
Practice Address - Fax:920-361-6339
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2018-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI60682-21208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1841496619Medicaid
WI014000416Medicare PIN