Individual
DR. EDWIN A. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-5000
Mailing address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40223
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258013600
—
MN
Enumeration date
12/22/2005
Last updated
04/03/2012
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