Individual
DR. WARNER J ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
218 COUSINS ROAD, VANDERWAGEN, NM 87326
(505) 507-3173
Mailing address
PO BOX 2559, GALLUP, NM 87305-2559
(505) 507-3173
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
83-6
NM
207R00000X
Internal Medicine Physician
83-6
NM
2083P0901X
Public Health & General Preventive Medicine Physician
83-6
NM
Other
Enumeration date
11/14/2005
Last updated
12/12/2016
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