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Individual

ROBERT W ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2101 JACKSON STREET, SUITE 111, ANDERSON, IN 46016
(765) 646-8557
(765) 646-8562
Mailing address
2101 JACKSON STREET, SUITE 111, ANDERSON, IN 46016
(765) 646-8557
(765) 646-8562

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01041764A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000079672
ANTHEM BLUE CROSS
01
110111180
MEDICARE RAILROAD
05
200026650B
IN
Enumeration date
11/27/2006
Last updated
06/17/2008
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