Individual
DR. TIMOTHY JOHN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 E NICOLLET BLVD, SUITE 200, BURNSVILLE, MN 55337-6732
(952) 898-5900
(952) 898-5914
Mailing address
3955 PARKLAWN AVE, SUITE 120, EDINA, MN 55435-5655
(952) 831-1944
(952) 278-6947
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30239
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1211637
MEDICA
MN
01
—
13183AN
BC/BS
MN
05
—
416282000
—
MN
01
—
FP9020802010
PREFERRED ONE
MN
Enumeration date
08/14/2006
Last updated
09/08/2008
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