Individual
DR. MICHELLE LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-5596
(218) 333-5594
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
7870A
WY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
107319
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126145200
—
WY
05
—
49473743
—
CO
Enumeration date
05/21/2007
Last updated
12/26/2013
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