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General NPI Number Information
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NPI Number | 1982623294
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Entity Type | Individual
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Provider Name | LYDIA H MILLER ANDERSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 319 N GRAHAM HOPEDALE RD SUITE A
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City | BURLINGTON
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State | NC
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Zip | 27217-2990
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Country | US
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Telephone | 336-513-4126
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Fax | 336-513-4203
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Provider Business Mailing Address
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Address Line | 202 ROSSBURN WAY
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City | CHAPEL HILL
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State | NC
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Zip | 27516-8343
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Country | US
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Telephone | 919-960-0019
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Fax | 919-960-0019
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9900949
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License Number State | NC
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