Individual
STEVEN LYNN ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16366 PRISTINE PINE CT, BRAINERD, MN 56401-6278
(218) 232-7928
Mailing address
16366 PRISTINE PINE CT, BRAINERD, MN 56401-6278
(218) 232-7928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40222
MN
207Q00000X
Family Medicine Physician
43122-020
WI
207Q00000X
Family Medicine Physician
8206A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106516500
—
MN
05
—
34109000
—
WI
Enumeration date
05/15/2006
Last updated
11/10/2011
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