Andersen, Blaine P

Andersen, Blaine P is an sole proprietor health care provider with primary practice located at 1300 N 500 E #260, Logan UT 84341-2408. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Surgery of the Hand is his primary health care specialty. Andersen, Blaine P can be contacted via phone (435) 753-3400.

Contact Information

Primary practice address
1300 N 500 E #260 Logan UT 84341-2408
Phone: (435) 753-3400
Fax: (435) 787-8887
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 1788161205 Utah
Allopathic & Osteopathic Physicians / Surgery of the Hand 2082S0105X 1788168905 Utah

Profile Details

NPI number 1538279609
LBN Legal business name Andersen, Blaine P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Nov 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538279609 NPPES
Idaho MEDICAID 003052200

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