Individual
DR. EDDIE EVAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 HOYLMAN DR, GASSAWAY, WV 26624-9321
(304) 364-5156
Mailing address
604 W MAIN ST, GLENVILLE, WV 26351-1058
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1995
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WV
Enumeration date
06/06/2006
Last updated
04/01/2020
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