Individual
DR. MARK ALLO ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 CAMPO RD, TIJERAS, NM 87059-7615
(505) 610-5421
Mailing address
40 CAMPO RD, TIJERAS, NM 87059-7615
(505) 610-5421
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301078206
MI
207Q00000X
Family Medicine Physician
45131-020
WI
Other
Enumeration date
08/10/2005
Last updated
11/26/2007
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