Provider Demographics
NPI:1679568216
Name:HUCKS, ANDREA DELL (MD)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DELL
Last Name:HUCKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:989 RIBAUT RD
Mailing Address - Street 2:STE 260
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5472
Mailing Address - Country:US
Mailing Address - Phone:843-522-7600
Mailing Address - Fax:843-522-7612
Practice Address - Street 1:989 RIBAUT RD
Practice Address - Street 2:STE 260
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5472
Practice Address - Country:US
Practice Address - Phone:843-522-7600
Practice Address - Fax:843-522-7612
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC18927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC110213340OtherRAILROAD MEDICARE
SC189272Medicaid
SCG785906305Medicare PIN
SC189272Medicaid