# DR. ANDERS MELLGREN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053320671
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208C00000X | Colon & Rectal Surgery Physician | 036.133002 | IL | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | 45364 | MN | — |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 07/08/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036.133002 | — | IL |
| 05 | — | 764487600 | — | MN |