Individual
DR. PAUL B ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000349
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016111370005
—
PA
01
—
0016673
DORAL
PA
01
—
1507182
GATEWAY
PA
01
—
2077435
AETNA
PA
01
—
3831-000
DAVIS
PA
01
—
919156
EYEMED
PA
01
—
AN515204
BC/BS
PA
01
—
NC251826952-2A11
ANTHEM
PA
Enumeration date
11/01/2006
Last updated
02/06/2024
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