Healthcare Provider Details

I. General information

NPI: 1033202825
Provider Name (Legal Business Name): PETER M. ANDERSON M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

R3 PEDIATRIC HEMATOLOGY/ONCOLOGY/BMT 9500 EUCLID AVE CLEVELAND CLINIC
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

R3 PEDIATRIC HEMATOLOGY/ONCOLOGY/BMT 9500 EUCLID AVE CLEVELAND CLINIC
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-308-2706
  • Fax:
Mailing address:
  • Phone: 216-308-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number26793
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number35.126229
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberM4688
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: