Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 26793 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | M4688 | TX |
NPI | 1033202825 |
---|---|
Provider Name | Peter M. Anderson |
First Address | Charlotte, NC 28260-1372 |
Second Address | Charlotte, NC 28203-5866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 19/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033202825 | (05) | NC |
177424201 | (05) | TX |
D81985 | (02) | |
NC1825 | (05) | SC |