Individual
CHARLES ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 JOHN Q HAMMONS DR, MADISON, WI 53717-1959
(608) 827-7705
Mailing address
1200 JOHN Q HAMMONS DR, MADISON, WI 53717-1959
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18844
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30174300
—
WI
Enumeration date
11/21/2005
Last updated
07/08/2007
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