Individual
DR. GARY L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3533 SOUTHERN BLVD, SUITE 2250, KETTERING, OH 45429-1264
(937) 534-0330
(937) 534-0340
Mailing address
3533 SOUTHERN BLVD STE 2250, KETTERING, OH 45429-1270
(937) 534-0330
(937) 522-8995
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34-00-4496A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0883021
—
OH
Enumeration date
02/23/2006
Last updated
11/18/2020
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