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NPI Code Detail

MEDICARE: MATTHEW CARL ANDERSON MD

MEDICARE: MATTHEW CARL 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
1207X00000XOrthopaedic Surgery Physician8639SD
2207X00000XOrthopaedic Surgery Physician1243605IA
3207XS0106XOrthopaedic Hand Surgery Physician1243605IA
4207XS0106XOrthopaedic Hand Surgery Physician8639SD

General Provider Information

NPI Number : 1477590925
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW CARL ANDERSON MD
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-6585
Fax Number : 605-328-6512
Provider Business Practice Location Address
First Line : 1210 W 18TH ST STE G01
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-4651
Country : US
Telephone Number : 605-328-2663
Fax Number : 605-328-3760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 03/25/2022

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