Individual
STEPHAN W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
840 HARRISON AVE, BOSTON, MA 02118-2905
(617) 638-6610
(617) 638-6616
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
227415
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110077068A
—
MA
05
—
3078937
—
NH
Enumeration date
08/18/2006
Last updated
03/04/2026
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