Individual
MICHAEL J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 PORT WASHINGTON ROAD, SUITE 110, GRAFTON, WI 53024-9201
(262) 387-8300
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
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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