Individual
JOHN KENNETH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2305 GENOA BUSINESS PARK DR STE 120, BRIGHTON, MI 48114-7004
(810) 494-6881
(810) 494-6882
Mailing address
24 FRANK LLOYD WRIGHT DR LBBY J2000, ANN ARBOR, MI 48105-9484
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
061034
MI
207X00000X
Orthopaedic Surgery Physician
Primary
4301061034
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3227715
—
MI
Enumeration date
01/31/2007
Last updated
02/05/2019
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