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1518027457

NPI Code Detail

MEDICARE: DR. MARY HAMILTON ANDERSON MD

MEDICARE: DR. MARY HAMILTON 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	207K00000X	Allergy & Immunology Physician	031554	GA
2	2080P0201X	Pediatric Allergy/Immunology Physician	31554	GA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518027457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY HAMILTON ANDERSON MD

Provider Business Mailing Address
First Line	:	P.O BOX 1758
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-3089
Country	:	US
Telephone Number	:	706-854-2500
Fax Number	:	706-854-2559

Provider Business Practice Location Address
First Line	:	411 TOWN BLVD
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-3089
Country	:	US
Telephone Number	:	706-854-2500
Fax Number	:	706-854-2559

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	02/07/2024

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Directions to “ DR. MARY HAMILTON ANDERSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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