Individual
KRISTY ELLEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7073 CLYO RD, CENTERVILLE, OH 45459-4816
(937) 435-5857
(937) 912-4960
Mailing address
36115 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.094249
OH
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
35.094249
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8M2522
BCBS
TX
Enumeration date
08/06/2007
Last updated
09/12/2014
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