MEDICARE: DAVID E ANDERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	4028	MT
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	4028	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063413789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E ANDERSON MD

Provider Business Mailing Address
First Line	:	1400 29TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-5353
Country	:	US
Telephone Number	:	406-454-2171
Fax Number	:	406-771-3021

Provider Business Practice Location Address
First Line	:	1917 4TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4149
Country	:	US
Telephone Number	:	406-453-7570
Fax Number	:	406-771-3021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	08/05/2011

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Directions to “ DAVID E ANDERSON MD” Practice Location

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