Individual
DR. PETER JON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1326
(712) 279-2010
(712) 279-2034
Mailing address
107 TOPPIN DR, HILTON HEAD, SC 29926-1005
(434) 242-1295
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01080422A
IN
207R00000X
Internal Medicine Physician
Primary
MD-41975
IA
208M00000X
Hospitalist Physician
39762
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64108459
—
KY
Enumeration date
06/08/2006
Last updated
06/12/2019
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