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General NPI Number Information
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NPI Number | 1750565081
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Entity Type | Organization
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Legal Business Name | DUDLEY B. ANDERSON, M.D., P.A.
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 1812 GLENDALE DR. SUITE B SW
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City | WILSON
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State | NC
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Zip | 27893
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Country | US
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Telephone | 252-291-3100
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Fax | 252-243-0599
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Provider Business Mailing Address
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Address Line | PO BOX 3146
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City | WILSON
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State | NC
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Zip | 27895-3146
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Country | US
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Telephone | 252-291-3100
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Fax | 252-243-0599
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Authorized Official
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Title or Position | OWNER
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Name | DR. DUDLEY BUIST ANDERSON
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Credential | M.D.
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Telephone | 252-291-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 17235
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License Number State | NC
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