Individual
ALYCE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 273-8383
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
77975
MN
207ND0900X
Dermatopathology Physician
Primary
77975
MN
390200000X
Student in an Organized Health Care Education/Training Program
MT218362
PA
Other
Enumeration date
06/19/2019
Last updated
02/07/2025
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