Individual
CHARLES R ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1121 JOHNSON FERRY RD, SUITE 100, MARIETTA, GA 30068-5425
(770) 509-1025
Mailing address
1121 JOHNSON FERRY RD, SUITE 100, MARIETTA, GA 30068-5425
(770) 509-1025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
054966
GA
Other
Enumeration date
06/12/2006
Last updated
07/09/2007
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