Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | C10003062 | DE |
NPI | 1003894817 |
---|---|
Provider Name | Paul C Anderson |
First Address | Wilmington, DE 19804-0048 |
Second Address | Newark, DE 19718-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000045301 | (05) | DE |
E52990 | (02) |