Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 2017004102 | MO |
NPI | 1548497498 |
---|---|
Provider Name | Dr. David Michael Anderson |
First Address | Tripler Army Medical Center, HI 96859-5001 |
Second Address | Tripler Army Medical Center, HI 96859-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | UPIN (01) |