Individual
MATTHEW LEE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 E MAIN ST, CENTRAL LAKES MEDICAL CLINIC PA, CROSBY, MN 56441-1645
(218) 546-7000
(218) 545-4456
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 546-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47166
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153479300
—
MN
Enumeration date
12/08/2005
Last updated
11/19/2020
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