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NPI Code Detail

MEDICARE: DAVID M ANDERSON M.D

MEDICARE: DAVID M 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
1207X00000XOrthopaedic Surgery Physician036116109IL

General Provider Information

NPI Number : 1821098013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M ANDERSON M.D
Provider Business Mailing Address
First Line : 101 W UNIVERSITY AVE
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61820-3981
Country : US
Telephone Number : 217-366-1237
Fax Number :
Provider Business Practice Location Address
First Line : 3101 FIELDS SOUTH DR
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61822-3743
Country : US
Telephone Number : 217-366-1237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 05/08/2024

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