Anderson, Michael

Anderson, Michael is an individual health care provider with primary practice located at 450 E Main St , Rexburg ID 83440-2048. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Anderson, Michael can be contacted via phone (208) 356-3691.

Contact Information

Primary practice address
450 E Main St Rexburg ID 83440-2048
Phone: (208) 356-3691
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ED0179A West Virginia
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X O-0885 Idaho

Profile Details

NPI number 1194019406
LBN Legal business name Anderson, Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2011
Last updated Apr 2nd, 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 1194019406 NPPES
Idaho MEDICAID 1346643038

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