Individual
JEFFREY B ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10297
ND
207Q00000X
Family Medicine Physician
52145
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14023
—
ND
05
—
16455
—
ND
Enumeration date
11/01/2006
Last updated
12/23/2020
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