Provider Demographics
NPI:1053572560
Name:CHEMA, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:CHEMA
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 1:3780 MEDINA RD STE 310
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9312
Mailing Address - Country:US
Mailing Address - Phone:330-725-8441
Mailing Address - Fax:330-725-8442
Practice Address - Street 1:3780 MEDINA RD STE 310
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9312
Practice Address - Country:US
Practice Address - Phone:330-725-8441
Practice Address - Fax:330-725-8442
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35094835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3066364Medicaid