Provider Demographics
NPI:1023092632
Name:OLAFSSON, ANDRI GAUKUR (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRI
Middle Name:GAUKUR
Last Name:OLAFSSON
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 1:37100 N GANTZEL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7350
Mailing Address - Country:US
Mailing Address - Phone:804-394-4480
Mailing Address - Fax:804-394-4521
Practice Address - Street 1:37100 N GANTZEL RD STE 107
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-7350
Practice Address - Country:US
Practice Address - Phone:480-394-4480
Practice Address - Fax:480-394-4521
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01849208600000X
NH10369208600000X
AZ48782208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE7915Medicare PIN
NHG80305Medicare UPIN