Healthcare Provider Details

I. General information

NPI: 1558991109
Provider Name (Legal Business Name): ANDERSON ONCOLOGIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 FRANCE AVE S STE 220
EDINA MN
55435-4792
US

IV. Provider business mailing address

11921 ORCHARD AVE W
MINNETONKA MN
55305-2938
US

V. Phone/Fax

Practice location:
  • Phone: 952-925-1111
  • Fax: 952-922-3446
Mailing address:
  • Phone: 126-868-1806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CASANDRA ANN ANDERSON
Title or Position: SURGICAL ONCOLOGIS
Credential: MD
Phone: 612-868-1806