Individual
DR. RICHARD THOMAS ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 PINE GROVE AVE, LABORATORY PORT HURON HOSPITAL, PORT HURON, MI 48060-3511
(810) 898-3234
(810) 985-6061
Mailing address
5158 LAKESHORE RD, FORT GRATIOT, MI 48059-3115
(810) 989-3234
(810) 985-6061
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301059987
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2869778
—
MI
Enumeration date
06/16/2006
Last updated
07/08/2007
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