Provider Demographics
NPI:1679554877
Name:BROBBEY, ANDREW KWABENA (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:KWABENA
Last Name:BROBBEY
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:PO BOX 32385
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-0385
Mailing Address - Country:US
Mailing Address - Phone:216-731-7110
Mailing Address - Fax:216-731-7130
Practice Address - Street 1:27900 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3539
Practice Address - Country:US
Practice Address - Phone:216-731-7110
Practice Address - Fax:216-731-7130
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083527B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00739536OtherRAILROAD MEDICARE
OH077098726026OtherCARESOURCE
OH000000359486OtherANTHEM BLUE CROSS
OH2478797Medicaid
OHP00739536OtherRAILROAD MEDICARE
I04261Medicare UPIN