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NPI Code Detail

MEDICARE: DR. PETER IAN ANDERSON M.D.

MEDICARE: DR. PETER IAN ANDERSON M.D.
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
1207P00000XEmergency Medicine Physician46504-020WI
2207P00000XEmergency Medicine PhysicianME98908FL
3207P00000XEmergency Medicine Physician100432AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
231422OTHERFLBCBS

General Provider Information

NPI Number : 1700866126
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER IAN ANDERSON M.D.
Provider Business Mailing Address
First Line : 250 HOSPITAL PL
Second Line :
City : SOLDOTNA
State : AK
Zip : 99669-6999
Country : US
Telephone Number : 907-714-4444
Fax Number :
Provider Business Practice Location Address
First Line : 250 HOSPITAL PL
Second Line :
City : SOLDOTNA
State : AK
Zip : 99669-6999
Country : US
Telephone Number : 907-714-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 10/07/2020

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