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NPI Code Detail

MEDICARE: ARLETHA ANDERSON, M.D. P.C.

MEDICARE: ARLETHA ANDERSON, M.D. P.C.
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
1207Q00000XFamily Medicine Physician4301071086MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10808272112OTHERMIBLUE CROSS PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578751467
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARLETHA ANDERSON, M.D. P.C.
Provider Business Mailing Address
First Line : 503 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48216-2200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 503 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48216-2200
Country : US
Telephone Number : 313-554-0227
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. ARLETHA LENISE ANDERSON
Credential : M.D.
Telephone Number : 313-587-4448
Provider Enumeration Date : 10/05/2007
Last Update Date : 10/05/2007

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