Provider Demographics
NPI:1679546030
Name:EFKEMAN, ANDREW (LPT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:EFKEMAN
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6811
Mailing Address - Country:US
Mailing Address - Phone:513-792-0777
Mailing Address - Fax:513-792-0061
Practice Address - Street 1:2475 W GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4368
Practice Address - Country:US
Practice Address - Phone:513-729-1798
Practice Address - Fax:513-729-2041
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT5246208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH270828495001OtherMEDICAL MUTUAL PROVIDER
OH000000178624OtherANTHEM PIN
OHQ01533Medicare UPIN
OH000000178624OtherANTHEM PIN