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General NPI Number Information
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NPI Number | 1952763328
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Entity Type | Individual
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Provider Name | ERIC R ANDERSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 1185 CORPORATE CTR DR
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4887
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Country | US
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Telephone | 262-785-0777
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Fax | 262-785-8029
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Provider Business Mailing Address
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Address Line | 20800 SWENSON DR STE 175
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City | WAUKESHA
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State | WI
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Zip | 53186-4000
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Country | US
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Telephone | 262-785-0777
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Fax | 262-785-0610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 2019018163
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 75798
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License Number State | WI
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