Provider Demographics
NPI:1174718035
Name:MCINNES, ANDREW DUNCAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DUNCAN
Last Name:MCINNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 EASTON AVE
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1766
Mailing Address - Country:US
Mailing Address - Phone:732-565-5434
Mailing Address - Fax:732-745-0857
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:732-565-5434
Practice Address - Fax:732-745-0857
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431091207LP3000X, 208000000X, 2080P0203X
NJ25MA089359002080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics