Individual
HENRY HARRISON ANDERSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5530B OLD NATIONAL HWY, COLLEGE PARK, GA 30349-3344
(404) 766-6001
(678) 336-7099
Mailing address
2795 MAIN ST W, BLDG 19B, SNELLVILLE, GA 30078-3164
(678) 252-2137
(678) 336-7099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033792
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000477309Q
—
GA
05
—
000477309R
—
GA
Enumeration date
05/12/2006
Last updated
12/10/2010
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