Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | APN2728 | SC |
Y | 207N00000X | Dermatologist | RN105862 | GA |
N | 207NP0225X | Pediatric Dermatologist | APN2728 | SC |
N | 207NP0225X | Pediatric Dermatologist | RN105862 | GA |
N | 207NS0135X | Procedural Dermatology | APN2728 | SC |
N | 207NS0135X | Procedural Dermatology | RN105862 | GA |
N | 363LA2200X | Nurse Practitioner - Adult Health | APN2728 | SC |
N | 363LA2200X | Nurse Practitioner - Adult Health | RN105862 | GA |
NPI | 1376651026 |
---|---|
Provider Name | Christopher J Anderson |
First Address | Savannah, GA 31419-1768 |
Second Address | Savannah, GA 31419-1768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
837663219A | (05) | GA |
837663219B | (05) | GA |
837663219C | (05) | GA |
837663219D | (05) | GA |
NP0945 | (05) | SC |
P95790 | (02) | GA |
P95790 | (02) | SC |