Provider Demographics
NPI:1902870959
Name:BURESH, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:BURESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21803 N SCOTTSDALE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7444
Mailing Address - Country:US
Mailing Address - Phone:480-585-4673
Mailing Address - Fax:480-585-4672
Practice Address - Street 1:21803 N SCOTTSDALE RD STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7444
Practice Address - Country:US
Practice Address - Phone:480-585-4673
Practice Address - Fax:480-585-4672
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30123207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1902870959OtherBCBS AZ
AZ813726Medicaid
AZ7602537OtherAETNA PROVIDER #
AZ7602537OtherAETNA PROVIDER #
AZ118367Medicare PIN