Doctor Name: | DR. RICHARD W ANDERSON |
NPI Number: | 1548335201 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME49948 |
Business Practice Address: | 1 Purlieu Place Suite 131 Winter Park, FL - 32792 |
Business Phone Number: | 4077407554 |
Business Fax Number: | 4077407751 |
Mailing Address: | 1 Purlieu Place, Suite 131 WINTER PARK |
State: | FL |
Postal Code: | 32792 |
Phone Number: | 4077407554 |
Fax Number: | 4077407751 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME49948 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |