| Doctor Name: | MR. ERIK JON ANDERSON |
| NPI Number: | 1376823682 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 306949 |
| Business Practice Address: | 2550 Som Center Rd Willoughby Hills, OH - 440949655 |
| Business Phone Number: | 4409432500 |
| Business Fax Number: | 4405168316 |
| Mailing Address: | 2550 Som Center Rd, WILLOUGHBY HILLS |
| State: | OH |
| Postal Code: | 440949655 |
| Phone Number: | 4409432500 |
| Fax Number: | 4405168316 |
| NPI Enumeration Date: | 08/18/2011 |
| NPI Last Update Date: | 07/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 306949 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |