Anderson, Mark Ian

Anderson, Mark Ian is an individual health care provider with primary practice located at 450 S Kitsap Blvd Ste 210 , Port Orchard WA 98366-3738. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Anderson, Mark Ian can be contacted via phone (360) 895-8950.

Contact Information

Primary practice address
450 S Kitsap Blvd Ste 210 Port Orchard WA 98366-3738
Phone: (360) 895-8950
Fax: (360) 895-8980
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01053155A Indiana
Allopathic & Osteopathic Physicians / Urology 208800000X MD60194935 Washington

Profile Details

NPI number 1215900303
LBN Legal business name Anderson, Mark Ian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Nov 12th, 2020 - about 5 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 1215900303 NPPES
Washington MEDICAID 2011203

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