Physician Compare National (NPI:1164474920)

HEALTHCARE PROVIDER: REGINA ANDERSON MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1164474920
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698962462
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101206000533
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANDERSON
	Individual professional last name
Provider First Name	REGINA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4100 N CHARLES ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 114
	Group Practice or individual's line 2 address
City	BALTIMORE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212181026
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4108897600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y