Healthcare Provider Details

I. General information

NPI: 1538135900
Provider Name (Legal Business Name): WILLIAM KARL ANDERSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 N POINTE BLVD STE 1
LANCASTER PA
17601
US

IV. Provider business mailing address

190 N POINTE BLVD STE 1
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-6444
  • Fax: 717-569-1044
Mailing address:
  • Phone: 717-560-6444
  • Fax: 717-569-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD061425L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD061425L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD061425L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: