Individual
DUANE RAY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 W IRONWOOD DR STE 202, COEUR D ALENE, ID 83814-4903
(208) 664-2175
(208) 664-1226
Mailing address
850 W IRONWOOD DR STE 202, COEUR D ALENE, ID 83814-4903
(208) 664-2175
(208) 664-1226
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M6376
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M6376
LICENSE
ID
Enumeration date
01/03/2007
Last updated
07/09/2007
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