Anderson, Keith Alan

Anderson, Keith Alan is an individual health care provider with primary practice located at 200 Greenwich Rd , Charlotte NC 28211-2316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, Keith Alan can be contacted via phone (704) 384-8680.

Contact Information

Primary practice address
200 Greenwich Rd Charlotte NC 28211-2316
Phone: (704) 384-8680
Fax: (704) 384-8684
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 133989 North Carolina

Profile Details

NPI number 1174652606
LBN Legal business name Anderson, Keith Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2007
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174652606 NPPES
North Carolina MEDICAID 5912419
North Carolina Other 133989
North Carolina MEDICAID N01507

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