Individual
DAVID GORDON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 COMMONWEALTH DR, SUITE 210, GREENVILLE, SC 29615-4831
(864) 675-4815
(864) 675-4780
Mailing address
135 COMMONWEALTH DR, SUITE 210, GREENVILLE, SC 29615-4831
(864) 675-4815
(864) 675-4780
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19440
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295769438
GROUP NPI
SC
05
—
194408
—
SC
01
—
8157
MEDICARE PTAN
SC
Enumeration date
05/11/2006
Last updated
05/02/2013
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