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Individual
ANTHONY ANDERSON
Active
Individual
ANTHONY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036119093
IL
207L00000X
Anesthesiology Physician
MDR7H67
MO
207Q00000X
Family Medicine Physician
Primary
036119093
IL
208VP0000X
Pain Medicine Physician
036119093
IL
208VP0014X
Interventional Pain Medicine Physician
036119093
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119093
—
IL
01
—
200132704
CDS
MO
05
—
205069909
—
MO
Enumeration date
05/12/2006
Last updated
03/07/2023
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