Individual
MARK ANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 365-6999
(719) 365-2837
Mailing address
PO BOX 973354, DALLAS, TX 75397-3354
(719) 365-6999
(719) 365-2837
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME36173
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001361732
—
CO
01
—
050054779
RAILROAD MEDICARE
CO
01
—
D4588
BLUE CROSS BLUE SHIELD
CO
Enumeration date
05/10/2006
Last updated
10/20/2014
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