Andrea Marie Kolongowski

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

22255 Greenfield Rd Ste 500
Southfield, MI 48075-3734

Phone

(248) 849-3186

Fax

(248) 849-3460

NPI assigned

Sep 24, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Andrea Marie Dotten Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1982073524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD STE 500",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753734",
            "telephone_number": "248-849-3186",
            "fax_number": "248-849-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD STE 500",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753734",
            "telephone_number": "248-849-3186",
            "fax_number": "248-849-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLONGOWSKI",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DOTTEN",
            "middle_name": "MARIE",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Sacks Kohn, MA LPC
• Selma Kokic
• Victoria Kolatski
• Toshia Kole-James, LMSW
• Bruce H Kole, MD
• Vian Koma
• David Komasara, D.O.
• Anitha Kompally, MD
• Sri Harshita Kondisetti
• Amy Lauren Konja

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.