Healthcare Provider Details
I. General information
NPI: 1396994026
Provider Name (Legal Business Name): DANIEL ROBERT ANDERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/18/2008
Last Update Date: 10/22/2022
Certification Date: 10/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 N JUSTICE ST
HENDERSONVILLE NC
28791
US
IV. Provider business mailing address
805 6 AVE W SUITE 100
HENDERSONVILLE NC
28739-4160
US
V. Phone/Fax
- Phone: 828-696-1000
- Fax:
- Phone: 828-693-7230
- Fax: 828-698-0583
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 78976 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 2016-00346 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 46316 |
| License Number State | TN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 46316 |
| License Number State | TN |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 2016-00346 |
| License Number State | NC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 78976 |
| License Number State | GA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 46316 |
| License Number State | TN |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 78976 |
| License Number State | GA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 2016-00346 |
| License Number State | NC |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 61348 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: