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Individual
MICHAEL ANDERSON
Active
Individual
MICHAEL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
O-0885
ID
207Q00000X
Family Medicine Physician
ED0179A
WV
Other
Enumeration date
06/03/2011
Last updated
04/02/2020
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