Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0727 | AZ |
NPI | 1043446131 |
---|---|
Provider Name | Dr. Robert Christopher Andersen |
First Address | Stockton, CA 95267-0096 |
Second Address | Gilbert, AZ 85298-4263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 18/04/2018 |