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Individual
THOMAS W ANDERSEN
Active
Individual
THOMAS W ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD033956E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010881200004
—
PA
01
—
01463001
CAPITAL BLUE CROSS
PA
01
—
053990
HIGHMARK BLUE SHIELD
PA
01
—
1085320
AETNA HMO
PA
01
—
51374 S1QG
GEISINGER HEALTH PLAN
PA
01
—
5491090
AETNA NON-HMO
PA
01
—
C28533
HEALTH ASSURANCE
PA
01
—
P002651
GATEWAY HEALTH PLAN
PA
Enumeration date
12/02/2005
Last updated
09/01/2007
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