Anderson, Edwin Walter
Anderson, Edwin Walter is an individual health care provider with primary practice located at 415 South State Street , Big Rapids MI 49307-2049. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Anderson, Edwin Walter can be contacted via phone (231) 296-3571.Contact Information
Primary practice address
415 South State Street
Big Rapids MI 49307-2049
Phone: (231) 296-3571
Fax: (231) 796-2211
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2901010102 | Michigan |
Profile Details
| NPI number | 1538237052 |
|---|---|
| LBN Legal business name | Anderson, Edwin Walter |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1538237052 | NPPES |
| Michigan | Other | D101020 | BCBS |
| Michigan | MEDICAID | 4054912 | BCBS |
| Michigan | Other | 652165 | BCBS |
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