Anderson, Stephan W

Anderson, Stephan W is an individual health care provider with primary practice located at 840 Harrison Ave , Boston MA 02118-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Anderson, Stephan W can be contacted via phone (617) 638-6610.

Contact Information

Primary practice address
840 Harrison Ave Boston MA 02118-2905
Phone: (617) 638-6610
Fax: (617) 638-6616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 227415 Massachusetts

Profile Details

NPI number 1235243122
LBN Legal business name Anderson, Stephan W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Jan 18th, 2022 - about 3 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 1235243122 NPPES
Massachusetts MEDICAID 110077068A

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