Basic Information
Provider Information
NPI: 1669457107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDREESCU
FirstName: DORIN
MiddleName: I
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2525 DESALES AVE
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374041161
CountryCode: US
TelephoneNumber: 4234952620
FaxNumber: 4234952625
Practice Location
Address1: 2525 DESALES AVE
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374041161
CountryCode: US
TelephoneNumber: 4234952620
FaxNumber: 4234952625
Other Information
ProviderEnumerationDate: 12/07/2005
LastUpdateDate: 11/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X39474TNN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X39474TNY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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