MEDICARE: DR. CRAIG S ANDERSON MD

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	207R00000X	Internal Medicine Physician	23416	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	348308	OTHER	CO	MEDICARE GROUP PTAN
3	C811604	OTHER	CO	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477541365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG S ANDERSON MD

Provider Business Mailing Address
First Line	:	2490 W 26TH AVE BLDG A
Second Line	:	SUITE 300
City	:	DENVER
State	:	CO
Zip	:	80211-5314
Country	:	US
Telephone Number	:	303-831-9393
Fax Number	:	303-468-9280

Provider Business Practice Location Address
First Line	:	2490 W 26TH AVE BLDG A
Second Line	:	SUITE 300
City	:	DENVER
State	:	CO
Zip	:	80211-5314
Country	:	US
Telephone Number	:	303-831-9393
Fax Number	:	303-468-9280

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	11/18/2016

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Directions to “ DR. CRAIG S ANDERSON MD” Practice Location

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