Healthcare Provider Details

I. General information

NPI: 1992911051
Provider Name (Legal Business Name): EINAR WULFSBERG ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 WOODLAND DR
COLUMBIA SC
29205-2069
US

IV. Provider business mailing address

911 WOODLAND DR
COLUMBIA SC
29205-2069
US

V. Phone/Fax

Practice location:
  • Phone: 803-782-0219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number11261
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number11261
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: