Provider Demographics
NPI:1174531503
Name:EDINGER, ANDREW MARTIN (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARTIN
Last Name:EDINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9315
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-522-4120
Practice Address - Street 1:905 US HIGHWAY 522
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870
Practice Address - Country:US
Practice Address - Phone:570-372-6102
Practice Address - Fax:570-372-6110
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044729E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01954002OtherCAPITAL BLUE CROSS
PA1268C3AKOtherGEISINGER
PA600441OtherBLUE SHIELD
PAP00092014OtherRAILROAD MEDICARE
PA01954002OtherKEYSTONE
PA12044440003Medicaid
PAE04994OtherHEALTH AMERICA
PA12044440003Medicaid
PA600441OtherBLUE SHIELD