Individual
MARK B ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, 3RD FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-8270
(215) 456-3533
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-2880
(551) 996-3984
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD445899
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330005347
RR MCR PTAN
NJ
05
—
8328102
—
NJ
Enumeration date
11/07/2006
Last updated
01/12/2017
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