Andrew Modic, MD

NPI #1063831972 in Ridgecrest, California

Provider Information

NPI Number: 1063831972
Entity Type: Individual
Name: Andrew Modic, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Apr 8, 2014
Last Updated: Feb 12, 2019

Practice Location

Address: 1111 N CHINA LAKE BLVD
City: Ridgecrest
State: California
ZIP Code: 93555-3131
Phone: (760) 499-3855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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