Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036142147 | IL |
Y | 207P00000X | Emergency Physician | MD2017-1020 | NM |
N | 207PE0004X | Emergency Medical Services | 37998 | NC |
NPI | 1114906609 |
---|---|
Provider Name | Dr. Christopher Anderson |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Mooresville, NC 28117-9620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 23/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7911160 | (05) | NC |
E30831 | (02) | NC |
N37998 | (05) | SC |