Individual
DR. GREGG W. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 DELAWARE ST SE, CLINIC 1E, COON RAPIDS, MN 55455
(612) 624-5915
Mailing address
720 WASHINGTON AV SE, 200, MINNEAPOLIS, MN 55414-1321
(612) 884-0649
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25801
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271802200
—
MN
Enumeration date
02/21/2006
Last updated
04/23/2012
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