Individual
MARK W ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0001
(434) 924-9400
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101055864
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101055864
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7202075
—
VA
Enumeration date
01/09/2007
Last updated
03/03/2025
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