MEDICARE: CHRISTIAN G ANDERSON MD PA

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	207R00000X	Internal Medicine Physician	19586	NC

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	:	1245426667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN G ANDERSON MD PA

Provider Business Mailing Address
First Line	:	502 W KING ST
Second Line	:	SUITE 100
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-3362
Country	:	US
Telephone Number	:	704-734-0576
Fax Number	:	704-730-1712

Provider Business Practice Location Address
First Line	:	502 W KING ST
Second Line	:	SUITE 100
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-3362
Country	:	US
Telephone Number	:	704-734-0576
Fax Number	:	704-730-1712

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. CHRISTIAN G ANDERSON
Credential	:	M.D.
Telephone Number	:	704-734-0576

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	09/03/2010

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