Individual
DAWN J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1445 MERRILL AVE, WAUSAU, WI 54401-2646
(715) 675-2321
(715) 675-6530
Mailing address
1445 MERRILL AVE, WAUSAU, WI 54401-2646
(715) 675-2321
(715) 675-6530
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
817-25
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007445003
MEDICARE PTAN
WI
05
—
43230600
—
WI
Enumeration date
07/12/2006
Last updated
12/05/2012
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