Individual
DR. DANIEL RICHARD ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
540 HOSPITAL DR, WINAMAC, IN 46996-1173
(574) 946-2194
Mailing address
PO BOX 279, WINAMAC, IN 46996-0279
(574) 946-2194
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL28992
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201204820
—
IN
Enumeration date
03/02/2007
Last updated
03/13/2020
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