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NPI Code Detail

MEDICARE: MICHAEL J ANDERSON MD

MEDICARE: MICHAEL J 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 Physician35450WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00742970OTHERWIRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558353243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J ANDERSON MD
Provider Business Mailing Address
First Line : 3003 W GOOD HOPE RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-2042
Country : US
Telephone Number : 414-352-3100
Fax Number :
Provider Business Practice Location Address
First Line : 975 PORT WASHINGTON ROAD
Second Line : SUITE 110
City : GRAFTON
State : WI
Zip : 53024-9201
Country : US
Telephone Number : 262-387-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 11/19/2021

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