Individual
MR. CHRISTIAN B ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
272 EAST CENTER STREET SUITE 102, IVINS, UT 84738-6456
(307) 413-3752
Mailing address
756 W SHINAVA DR, IVINS, UT 84738-6713
(307) 413-3752
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
7168A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12134634-1204
STATE LISCENSE NUMBER
UT
01
—
7168A
STATE LISCENSE NUMBER
WY
Enumeration date
01/29/2007
Last updated
09/18/2024
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