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Individual

DR. SCOTT R ANDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10240 PARK MEADOWS DR, LONE TREE, CO 80124-5425
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42617
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0062769
OH
01
026810
KAISER COMMERCIAL NUMBER
CO
05
10025709000
NE
05
121183800
WY
05
1851376347
SD
05
1851376347
UT
05
200376720A
KS
05
20922850
CO
05
28102517
NM
05
84-059792913
NE
05
929010
AZ
01
P00312918
RR RIA MEDICARE
CO
01
P00385462
RR MIC MEDICARE
CO
01
P00720342
RR MCR NE
NE
Enumeration date
12/07/2005
Last updated
06/10/2021
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