Individual
IAN P ANDERSON
Active
Individual
IAN P ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TP861
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000718931
ANTHEM - NCMA
KY
01
—
000057120R
HUMANA - NCMA
KY
01
—
126735
SIHO - NCMA
KY
01
—
201033230
MEDICAID - NCMA
IN
01
—
50033806
PASSPORT - NCMA
KY
05
—
7100164430
—
IN
05
—
7100164430
—
KY
Enumeration date
06/06/2008
Last updated
09/17/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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