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NPI Code Detail

MEDICARE: DR. ERIC CARL ANDERSON M.D., PH.D.

MEDICARE: DR. ERIC CARL ANDERSON M.D., PH.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
1207R00000XInternal Medicine PhysicianMD28270OR
2207RH0003XHematology & Oncology PhysicianMD28270OR

General Provider Information

NPI Number : 1477765493
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC CARL ANDERSON M.D., PH.D.
Provider Business Mailing Address
First Line : PO BOX 3390
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3390
Country : US
Telephone Number : 503-215-6019
Fax Number :
Provider Business Practice Location Address
First Line : 810 12TH ST
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1587
Country : US
Telephone Number : 541-387-1338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 10/27/2023

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