Individual
ANDREW KARL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
316 CALHOUN ST, RADIOLOGY DEPARTMENT, CHARLESTON, SC 29401-1113
(843) 724-2988
Mailing address
PO BOX 2363, INDIANAPOLIS, IN 46206-2363
(843) 724-2988
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
059359
GA
2085R0202X
Diagnostic Radiology Physician
Primary
30790
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073729711
BCBSSC
SC
05
—
307901
—
SC
01
—
P00645078
RAILROAD MEDICARE
SC
Enumeration date
05/16/2007
Last updated
02/13/2014
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