Individual
DR. MARSHALL W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1234 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-1234
(336) 538-2390
Mailing address
PO BOX 1717, BURLINGTON, NC 27216-1717
(336) 538-1234
(336) 538-2390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0095-00299
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2214153B
MEDICARE PTAN
NC
05
—
8911227
—
NC
Enumeration date
06/09/2006
Last updated
03/05/2013
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