Aedra D. Andrade, MD

Family Medicine in Gallup, NM. Individual provider (NPI-1).

NPI number1164435673

StatusActive

Last updated in NPPESAug 1, 2023

Details

NPI: 1164435673
Entity type: Individual (NPI-1)
Name: Aedra D. Andrade
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: Aug 14, 2006
Certification date: Aug 1, 2023
Last updated: Aug 1, 2023

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - FAMILY PRACTICE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	NM2003-0155	NM	Yes

Other names

Aedra Dawn Wenger (Former Name)

Practice location

610 N 5th St
Gallup, NM 87301-5306

Phone 505-863-3120 · Fax 505-863-2691

Mailing address

1504 Fairway Cir
Gallup, NM 87301-4937

Phone 505-722-5008 · Fax 505-722-5008

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Other Family Medicine Physician providers in Gallup, NM

All 31 Family Medicine Physician providers in Gallup · All 2,281 providers in Gallup

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