Individual
MR. EDWARD CARL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2166 MADISON AVE, GRANITE CITY, IL 62040-4700
(618) 452-3301
(618) 452-3312
Mailing address
2166 MADISON AVE, GRANITE CITY, IL 62040-4700
(618) 452-3301
(618) 452-3312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000938
IL
363A00000X
Physician Assistant
109142
MO
Other
Enumeration date
12/28/2006
Last updated
08/09/2021
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