Doctor Name: | SETH ANDERSON |
NPI Number: | 1528210879 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | RL10952 |
Business Practice Address: | 801 Broadway N Fargo, ND - 581023641 |
Business Phone Number: | 7012342000 |
Business Fax Number: | |
Mailing Address: | Po Box 2168, FARGO |
State: | ND |
Postal Code: | 581072168 |
Phone Number: | 7012342110 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2008 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | RL10952 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |