DR. ANDRE LEVESTER MCCOLLOUGH (NPI# 1316294200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316294200 |
| Entity Type | Individual |
| Full Name | DR. ANDRE LEVESTER MCCOLLOUGH |
| Credential | M.D. |
| Practice Address |
4455 Edison Lakes Pkwy Mishawaka IN 46545-1414 |
| Mailing Address |
623 Macon St Apt 3 Brooklyn NY 11233-1515 |
| Practice Telephone | 5742316134 |
| Practice Fax Number | 5742316845 |
| Mailing Telephone | 6462518679 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2019-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 01078115A | IN | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 281409 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3125 Transverse Drive, Ruppert Health Center, Toledo, OH 436142595 | 4193836119 | 4193833234 |
| Street Address |
4455 EDISON LAKES PKWY |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-1414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891787321 | United Surgeons LLC | Clinic/Center | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2005-08-19 |
| 1023668423 | Labcorp Indiana Inc | Clinical Medical Laboratory | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1414 | 2019-09-17 |
| 1477094332 | Michael Poulsen | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2017-03-13 |
| 1437600541 | Unity Hospitalist LLC | Hospitalist | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2016-10-24 |
| 1932650181 | Daniel Aizigov | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2016-10-21 |
| 1164896130 | Somnium Dme LLC | Durable Medical Equipment & Medical Supplies | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2015-11-13 |
| 1689063497 | Cheryl Yancey | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2015-01-16 |
| 1255732020 | Michael Myers | Pharmacist | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2014-09-11 |
| 1225441975 | United Surgeons, LLC | Pharmacy | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2014-06-10 |
| 1306194667 | Furhan Rashid Qureshi | Emergency Medicine | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2012-08-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| 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 |
|---|---|---|---|---|
| 1538653001 | Premier Internal Medicine LLC | Internal Medicine | 520 Park Place Ct Ste 300, Mishawaka, IN 46545-3581 | 2018-06-19 |
| 1992960850 | Won K Chung | Internal Medicine | 3838 N Main St Ste 1c, Mishawaka, IN 46545-3100 | 2008-07-21 |
| 1548476120 | Alexander C Gatzimos | Internal Medicine | 212 West Edison Road, Suite B, Mishawaka, IN 46545 | 2007-05-14 |
| 1740235183 | Dahan Hussein Al-fadhl | Internal Medicine | 611 E Douglas, Suite 309, Mishawaka, IN 46545-1467 | 2006-05-24 |
| 1912952151 | Shaya Mokfi | Internal Medicine | 520 Park Place Ct, Ste 300, Mishawaka, IN 46545-3581 | 2006-05-24 |
| 1770574014 | Richard Joel Wein | Internal Medicine | 3625 Park Pl W, Ste 100, Mishawaka, IN 46545-3561 | 2005-11-04 |
| 1356345797 | Thomas P Varied | Internal Medicine | 5215 Holy Cross Parkway, Mishawaka, IN 46545-1469 | 2005-06-13 |
| 1881211878 | Aims-med, LLC | Internal Medicine | 1113 Mossy Ln, Mishawaka, IN 46544-9055 | 2020-06-25 |
| 1366097016 | Mids, LLC | Internal Medicine | 3838 N Main St Ste 1c, Mishawaka, IN 46545-3100 | 2019-08-08 |
| 1033697529 | Hospitalist Medicine Physicians of Indiana-tcg, LLC | Internal Medicine | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-08-06 |
| Find all providers in MISHAWAKA | ||||
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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.