Desruisseau, Andrew James

Desruisseau, Andrew James is an sole proprietor health care provider with primary practice located at 3569 Round Barn Cir , Santa Rosa CA 95403-1757. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Desruisseau, Andrew James can be contacted via phone (707) 303-3600.

Contact Information

Primary practice address
3569 Round Barn Cir Santa Rosa CA 95403-1757
Fax: (707) 303-3611
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X C54607 California
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 38871 Tennessee

Profile Details

NPI number 1518945658
LBN Legal business name Desruisseau, Andrew James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2006
Last updated Apr 19th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518945658 NPPES
Tennessee MEDICAID 3897593

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