Provider Demographics
NPI:1053405605
Name:PARAD, ANDREW M (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:PARAD
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 1:2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND
Mailing Address - Street 2:ATTN: MEDICAL STAFF SERVICES BLDG. H
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32212-0140
Mailing Address - Country:US
Mailing Address - Phone:843-228-4237
Mailing Address - Fax:
Practice Address - Street 1:1104 CALINDA DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-8372
Practice Address - Country:US
Practice Address - Phone:850-505-6472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24787207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine