Anderson, Edward Michael
Anderson, Edward Michael is an sole proprietor health care provider with primary practice located at 1 Lincoln Parkway Suite 202, Hattiesburg MS 39402. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Anderson, Edward Michael can be contacted via phone (601) 288-8050.Contact Information
Primary practice address
1 Lincoln Parkway Suite 202
Hattiesburg MS 39402
Phone: (601) 288-8050
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 36643 | Mississippi |
Profile Details
| NPI number | 1972546075 |
|---|---|
| LBN Legal business name | Anderson, Edward Michael |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jan 15th, 2008 - 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 | 1972546075 | NPPES |
| Mississippi | MEDICAID | 00122156 |
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