Anderson, Gregg W.
Anderson, Gregg W. is an individual health care provider with primary practice located at 516 Delaware St Se Clinic 1E, Coon Rapids MN 55455. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Anderson, Gregg W. can be contacted via phone (612) 624-5915.Contact Information
Primary practice address
516 Delaware St Se Clinic 1E
Coon Rapids MN 55455
Phone: (612) 624-5915
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 25801 | Minnesota |
Profile Details
| NPI number | 1962477323 |
|---|---|
| LBN Legal business name | Anderson, Gregg W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Apr 23rd, 2012 - about 13 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 | 1962477323 | NPPES |
| Minnesota | MEDICAID | 271802200 |
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