Individual
DR. JEFFREY DEAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Mailing address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8049
IA
2085R0202X
Diagnostic Radiology Physician
Primary
52902
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073716072
—
WI
Enumeration date
06/07/2007
Last updated
10/01/2018
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