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NPI Code Detail

MEDICARE: CYNTHIA A ANDERSON

MEDICARE:   CYNTHIA A ANDERSON
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
1207N00000XDermatology Physician9503MN
2363A00000XPhysician Assistant0726SD

General Provider Information

NPI Number : 1265495535
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA A ANDERSON
Provider Business Mailing Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-721-8354
Fax Number : 605-721-8458
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-721-8354
Fax Number : 605-721-8458
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 01/22/2010

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Directions to “ CYNTHIA A ANDERSON ” Practice Location

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