Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | ME32575 | FL |
NPI | 1316063357 |
---|---|
Provider Name | Timothy M Anderson |
First Address | West Palm Beach, FL 33409-6501 |
Second Address | West Palm Beach, FL 33409-6501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 08/04/2015 |