Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD061425L | PA |
N | 207ND0900X | Dermatopathologist | MD061425L | PA |
NPI | 1538135900 |
---|---|
Provider Name | Dr. William Karl Andersen |
First Address | Lancaster, PA 17601 |
Second Address | Lancaster, PA 17601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 07/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F97763 | (02) |