Individual
KENT W ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
504 6TH ST, DEPARTMENT OF RADIATION ONCOLOGY, LEWISTON, ID 83501-2439
(208) 799-5600
Mailing address
PO BOX 1829, COEUR D ALENE, ID 83816-1829
(208) 667-9334
(208) 664-2341
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
M5576
ID
Other
Enumeration date
08/28/2006
Last updated
07/09/2007
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