Individual
DEREK ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3624 N 14TH ST, SAINT LOUIS, MO 63107-3703
(314) 541-8131
Mailing address
3624 N 14TH ST, SAINT LOUIS, MO 63107-3703
(314) 541-8131
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
2010014757
—
251E00000X
Home Health Agency
Primary
2010014757
MO
332BC3200X
Customized Equipment (DME)
2010014757
MO
343900000X
Non-emergency Medical Transport (VAN)
2010014757
MO
Other
Enumeration date
01/01/2022
Last updated
01/01/2022
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