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General NPI Number Information
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NPI Number | 1326819574
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Entity Type | Organization
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Legal Business Name | ANDERSON PODIATRY PC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 30301 WOODWARD AVE STE 120
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City | ROYAL OAK
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State | MI
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Zip | 48073-0981
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Country | US
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Telephone | 248-435-6622
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Fax |
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Provider Business Mailing Address
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Address Line | 2829 RAMBLING WAY
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City | BLOOMFIELD TOWNSHIP
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State | MI
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Zip | 48302-1046
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Country | US
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Telephone | 248-227-1736
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Fax |
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Authorized Official
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Title or Position | WNER
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Name | DR. RHODONNA ANDERSON
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Credential | PODIATRIST
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Telephone | 248-227-1736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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