Healthcare Provider Details

I. General information

NPI: 1841520624
Provider Name (Legal Business Name): RONALD L ANDERSON, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2009
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE STE 102
WASHINGTON DC
20020-7033
US

IV. Provider business mailing address

2041 MARTIN LUTHER KING JR AVE SE STE 102
WASHINGTON DC
20020-7033
US

V. Phone/Fax

Practice location:
  • Phone: 202-889-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MONTEZ ANDERSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 202-889-5700