Individual
DR. JOHN MICHAEL ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
773
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06749
BCBS
—
Enumeration date
01/18/2007
Last updated
08/16/2018
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