# DR. PETER JON ANDERSON

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

## Provider details

- **NPI number:** 1114967858
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 01080422A | IN | — |
| 207R00000X | Internal Medicine Physician | MD-41975 | IA | Yes |
| 208M00000X | Hospitalist Physician | 39762 | KY | — |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 06/12/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64108459 | — | KY |