Anderson, Charles W
Anderson, Charles W is an individual health care provider with primary practice located at 123 Cruz Alta , Taos NM 87571-6279. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Anderson, Charles W can be contacted via phone (505) 758-8651.Contact Information
Primary practice address
123 Cruz Alta
Taos NM 87571-6279
Phone: (505) 758-8651
Fax: (505) 758-7811
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 64-23 | New Mexico |
Profile Details
| NPI number | 1164480133 |
|---|---|
| LBN Legal business name | Anderson, Charles W |
| Credentials | MEDICAL DOCTOR |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Aug 31st, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164480133 | NPPES |
| New Mexico | MEDICAID | 1305 |
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