Individual
DR. EDWIN GWIN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT643
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ODT643
STATE LICENSE NUMBER
TN
Enumeration date
04/27/2006
Last updated
10/23/2014
Update your record
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