Individual
MR. JOHN MARTIN ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
933 N CHARLOTTE STREET, 3-A, POTTS, PA 19464-3974
(610) 323-9052
(610) 323-3085
Mailing address
933 N CHARLOTTE STREET, 3-A, POTTS, PA 19464-3974
(610) 323-9052
(610) 323-3085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 039149E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000506727
CAPITAL BLUE CROSS
—
05
—
0011067390001
—
PA
01
—
0109636001
KHPE/IBC
PA
01
—
018149
AETNA HMO
PA
01
—
1025953
KEYSTONEMERCY HEALTH PLAN
—
01
—
232925465
BERKSHIRE HEALTH PLANS
—
Enumeration date
08/22/2006
Last updated
10/17/2011
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