Individual
WAYNE JULIUS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 E COLORADO BLVD, SPEARFISH, SD 57783-2776
(605) 642-2030
Mailing address
550 E COLORADO BLVD, SPEARFISH, SD 57783-2776
(605) 642-2030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1344
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007482
WELLMARK BCBS
SD
01
—
1344
DAKOTA CARE
SD
Enumeration date
06/29/2006
Last updated
07/08/2007
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