Healthcare Provider Details
I. General information
NPI: 1447279005
Provider Name (Legal Business Name): JAMES M ANDERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11100 EUCLID AVE
CLEVELAND OH
44106-1716
US
IV. Provider business mailing address
24701 EUCLID AVE 3RD FLORR
EUCLID OH
44117-1714
US
V. Phone/Fax
- Phone: 216-844-7494
- Fax: 216-286-6341
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0101X |
| Taxonomy | Anatomic Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZB0001X |
| Taxonomy | Blood Banking & Transfusion Medicine Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0104X |
| Taxonomy | Chemical Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0006X |
| Taxonomy | Clinical Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0105X |
| Taxonomy | Clinical Pathology/Laboratory Medicine Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZF0201X |
| Taxonomy | Forensic Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZH0000X |
| Taxonomy | Hematology (Pathology) Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZI0100X |
| Taxonomy | Immunopathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZM0300X |
| Taxonomy | Medical Microbiology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0007X |
| Taxonomy | Molecular Genetic Pathology (Pathology) Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZN0500X |
| Taxonomy | Neuropathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0213X |
| Taxonomy | Pediatric Pathology Physician |
| License Number | 35-043043 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
