Individual
DR. KEITH ALAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 GREENWICH RD, CHARLOTTE, NC 28211-2316
(704) 384-8680
(704) 384-8684
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-8680
(704) 384-8684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
133989
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133989
LICENSE
NC
05
—
5912419
—
NC
05
—
N01507
—
SC
Enumeration date
03/02/2007
Last updated
03/07/2023
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