Anderson, Mark

Anderson, Mark is an individual health care provider with primary practice located at 800 Medical Center Dr , Fairmont MN 56031-4575. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Anderson, Mark can be contacted via phone (507) 238-8555.

Contact Information

Primary practice address
800 Medical Center Dr Fairmont MN 56031-4575
Phone: (507) 238-8555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP1721 Minnesota

Profile Details

NPI number 1942285192
LBN Legal business name Anderson, Mark
Credentials PHD LP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942285192 NPPES
Minnesota MEDICAID 114910
Minnesota Other 40D59AN
Minnesota MEDICAID 40D59AN
Minnesota Other 7314
Minnesota Other HP18890
Minnesota Other A031
Minnesota Other MH9041009757
Minnesota Other 862668

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