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Individual

MICHAEL J ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35450
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32052500
WI
01
P00742970
RR MEDICARE
WI
Enumeration date
08/18/2005
Last updated
11/19/2021
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