Basic Information
| Provider Information | |||||||||
| NPI: | 1669413332 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDREASSI | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 60447 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043847840 | ||||||||
| FaxNumber: | 7043847830 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 MATTHEWS TOWNSHIP PKWY STE 200 | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | MATTHEWS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281055403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043846901 | ||||||||
| FaxNumber: | 7043846902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 10/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9600217 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 179514 | 01 | NC | WELLPATH | OTHER | P00256325 | 01 | NC | RR MEDICARE | OTHER | 891037R | 05 | NC | MEDICAID | 5717476 | 01 | NC | AETNA | OTHER | 9734021003 | 01 | NC | CIGNA | OTHER | C0098 | 01 | NC | MEDCOST | OTHER | 04-56039 | 01 | NC | UNITED HEALTHCARE | OTHER | 1037R | 01 | NC | BCBSNC | OTHER | 200157944 | 01 | NC | TRICARE | OTHER | 17457 | 01 | NC | PARTNERS | OTHER |