Wallace M Anderson in Edwardsville - Diagnostic Radiology
Wallace M Anderson - NPI 1578510913
Wallace M Anderson is a Diagnostic Radiology in Edwardsville, Illinois. Wallace M Anderson practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Wallace M Anderson is 1578510913. The last update date is 2008-04-17.
Wallace M Anderson's current location address is Po Box 662, Edwardsville, Illinois. You can contact this provider via phone number 8778335034 and fax number 4059486507. The mailing address for Wallace M Anderson is Po Box 662, Edwardsville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wallace M Anderson |
|---|---|
| Address | Po Box 662, Edwardsville, Illinois |
| Phone Number | 8778335034 |
| Fax Number | 4059486507 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1578510913 |
|---|---|
| Provider Enumeration Date | 2006-05-30 |
| Last Updated Date | 2008-04-17 |
Provider Mailing Address Detail
| Address | Po Box 662 |
|---|---|
| City | Edwardsville |
| State | Illinois (IL) |
| Post Code | 620250662 |
| Phone Number | 8778335034 |
| Fax Number | 4059486507 |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | 36082306 |
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Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 360823063 | IL | -- | |
| 1333997 | TN | BCBS OF TN |
Post Comment/ Review Below
What is the Wallace M Anderson's 1578510913?
The Wallace M Anderson's NPI (National Provider Identifier) Number is 1578510913. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Wallace M Anderson's facilities are situated?
The facilities of Wallace M Anderson are physically located at the following address: Po Box 662, Edwardsville, IL, 620250662.
What is the Wallace M Anderson's area of specialization and corresponding taxonomy classification?
The Wallace M Anderson's specialty field is Diagnostic Radiology, and it falls under the taxonomy code 2085R0202X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1578510913 to Wallace M Anderson?
The Centers for Medicare & Medicaid Services assigned the 1578510913 to Wallace M Anderson on 2006-05-30.
As of what date were the details pertaining to Wallace M Anderson last refreshed?
The information related to the Wallace M Anderson, including its address, specialty, and other relevant details, was last updated on 2008-04-17.