Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD043446L | PA |
N | 207VX0000X | Obstetrician | MD043446L | PA |
NPI | 1427026970 |
---|---|
Provider Name | Dr. Elizabeth Anderson |
First Address | Williamsport, PA 17701-1900 |
Second Address | Williamsport, PA 17701-3100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 04/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E89110 | (02) |