Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 039701 | OH |
NPI | 1033101431 |
---|---|
Provider Name | Dr. Craig Warren Anderson |
First Address | Columbus, OH 43215-4354 |
Second Address | Columbus, OH 43215-4354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0432606 | (05) | OH |
A16030 | (02) |