Individual
MISHA A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3607 N RIDGE RD, WICHITA, KS 67205-1230
(316) 721-2701
(316) 721-8612
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1710
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200347590A
—
KS
01
—
CD2825
RAIL ROAD MEDICARE GROUP
KS
01
—
P00349094
RAIL ROAD MEDICARE
KS
Enumeration date
03/01/2006
Last updated
12/06/2013
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