Anderson, Renner S

Anderson, Renner S is an sole proprietor health care provider with primary practice located at 15111 Twelve Oaks Center Dr , Minnetonka MN 55305-5201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Anderson, Renner S can be contacted via phone (952) 993-4500.

Contact Information

Primary practice address
15111 Twelve Oaks Center Dr Minnetonka MN 55305-5201
Phone: (952) 993-4500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 24434 Minnesota

Profile Details

NPI number 1902883556
LBN Legal business name Anderson, Renner S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 26th, 2005
Last updated Oct 20th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902883556 NPPES
Minnesota MEDICAID 699503900

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