MEDICARE: MS. DANITA ANDERSON MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	00027672	AL
2	207Q00000X	Family Medicine Physician	MD.204101	LA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	515-37495	OTHER	AL	BLUECROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	I61597	OTHER	AL	HEALTHSPRING OF ALABAMA
5	51537501	OTHER	AL	BLUECROSS BLUESHIELD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	515-37494	OTHER	AL	BLUECROSS BLUESHIELD
9	515-37496	OTHER	AL	BLUECROSS BLUESHIELD
10	515-37499	OTHER	AL	BLUECROSS BLUESHIELD
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	51537500	OTHER	AL	BLUECROSS BLUESHIELD
13	515-37498	OTHER	AL	BLUECROSS BLUESHIELD
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1982702486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANITA ANDERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 4148
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70178-4148
Country	:	US
Telephone Number	:	504-212-9518
Fax Number	:	504-212-9534

Provider Business Practice Location Address
First Line	:	4710 S CARROLLTON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6027
Country	:	US
Telephone Number	:	504-454-9020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	11/04/2019

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax: