MEDICARE: WILLIAM MARTIN ANDERSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	M-5426	ID

General Provider Information

NPI Number	:	1174508485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MARTIN ANDERSON M.D.

Provider Business Mailing Address
First Line	:	1129 SW LOPEZ DR
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-2276
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	US NAVAL HOSPITAL, 3475 N. SARATOGA ST..
Second Line	:	SURGERY CLINIC
City	:	OAK HARBOR
State	:	WA
Zip	:	98278-0001
Country	:	US
Telephone Number	:	360-257-9594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	07/08/2007

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