# JEFFREY B ANDERSEN

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

## Provider details

- **NPI number:** 1184701856
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10297 | ND | Yes |
| 207Q00000X | Family Medicine Physician | 52145 | MN | — |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 12/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 14023 | — | ND |
| 05 | — | 16455 | — | ND |