Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35086755 | OH |
N | 208600000X | Surgeon | 35086755 | OH |
N | 2086S0102X | Surgical Critical Care | 35086755 | OH |
Y | 2086S0102X | Surgical Critical Care | 4301050681 | MI |
N | 2086S0127X | Trauma Surgeon | 35086755 | OH |
N | 2086S0127X | Trauma Surgeon | 4301050681 | MI |
NPI | 1083670061 |
---|---|
Provider Name | Dr. Harry L Anderson III |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-1051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 20/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2597846 | (05) | OH |
F07112 | (02) |