Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD052880L | PA |
NPI | 1003846817 |
---|---|
Provider Name | Dr. Donald H Andersen |
First Address | West Chester, PA 19380-4269 |
Second Address | West Chester, PA 19380-4269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 25/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F86922 | (02) | PA |