DR. ANDREW WALLER (NPI# 1053334219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053334219 |
| Entity Type | Individual |
| Full Name | DR. ANDREW WALLER |
| Credential | MD |
| Practice Address |
5361 Mcauley Dr Ypsilanti MI 48197-1011 |
| Mailing Address |
24 Frank Lloyd Wright Dr Lobby J Ann Arbor MI 48105-9484 |
| Practice Telephone | 7347121300 |
| Practice Fax Number | 7342223665 |
| Mailing Telephone | 7347476766 |
| Mailing Fax Number | 7342223100 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | AW406915 | MI | Allopathic & Osteopathic Physicians |
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
4301406915 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4200 Whitehall Dr Ste 250, Ann Arbor, MI 481059694 | 7346225016 | 7346225017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245686229 | Andrew Paul Waller | Psychiatry & Neurology | 920 Stanton L Young Blvd, G. Rainey Williams Pavilion - 3rd Floor, Oklahoma City, OK 73104-5036 | 2016-05-10 |
| Street Address |
5361 MCAULEY DR |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003817529 | Michael Sanson | Internal Medicine | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2005-08-09 |
| 1881244671 | Max Julien | Physician Assistant | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2019-09-13 |
| 1275196651 | Melissa Miller | Nurse Practitioner | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2019-04-21 |
| 1619466968 | Trinity Continuing Care Services | Assisted Living Facility | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2018-05-02 |
| 1225526023 | Leah Pappas | Nurse Practitioner | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2018-04-26 |
| 1083061832 | Kaitlin Rebecca Zeytuncu | Family Medicine | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2016-05-23 |
| 1417375452 | Daniel Jeung | Internal Medicine | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2014-04-06 |
| 1669896759 | Danielle Wilseck | Physician Assistant | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2014-02-10 |
| 1013276260 | Iha Health Services Corporation | Family Medicine | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2012-05-09 |
| 1992061485 | Sara Ann Fox | Internal Medicine | 5361 Mcauley Dr, Ypsilanti, MI 48197-1011 | 2012-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659627321 | Alex Eskander Moyyad | Internal Medicine | 8277 S. Huron River Drive, Alex E Moyyad, M.d., Ypsilanti, MI 48197 | 2012-07-31 |
| 1033476189 | Kashyap Babubhai Patel | Internal Medicine | 5333 Mcauley Drive, Suite 4001, Academic Internal Medicine, Ypsilanti, MI 48197-8633 | 2012-04-13 |
| 1629201827 | Phillip Webb Dooley Jr. | Internal Medicine | 9665 E Hereford Dr, Ypsilanti, MI 48197-1874 | 2009-09-03 |
| 1700049210 | Ann Cotcamp Wilkie | Internal Medicine | 5301 Mcauley Drive, Ypsilanti, MI 48197-5368 | 2008-07-03 |
| 1669650867 | Margaret Balemba Mekai Vekima | Internal Medicine | 5429 Whittaker Rd, Ypsilanti, MI 48197-9751 | 2008-02-11 |
| 1033313473 | Adelina W Herrero Md PC | Internal Medicine | 316 Ecorse Rd Ste 100, Ypsilanti, MI 48198-5732 | 2007-06-11 |
| 1821214925 | Jean Butler Cederna | Internal Medicine | 103 Arnet St, Ypsilanti, MI 48198-5706 | 2007-04-17 |
| 1699817833 | Binju Joel | Internal Medicine | 3145 W Clark Rd Ste 401, Ypsilanti, MI 48197-1120 | 2007-02-13 |
| 1740340264 | Adelina W Herrero | Internal Medicine | 107 Ferris St, Ypsilanti, MI 48197-5412 | 2006-12-12 |
| 1285651240 | Therese Benevich | Internal Medicine | 4940 W Clark Rd Ste 100, Ypsilanti, MI 48197-0860 | 2006-07-16 |
| Find all providers in YPSILANTI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.