Healthcare Provider Details

I. General information

NPI: 1720108400
Provider Name (Legal Business Name): CHRISTOPHER DAVID ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 04/10/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 FENWOOD RD
BOSTON MA
02115-6128
US

IV. Provider business mailing address

115 ALBERT RD
AUBURNDALE MA
02466-1300
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-7432
  • Fax:
Mailing address:
  • Phone: 312-498-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number238904
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: