Anderson, Mark Doran

Anderson, Mark Doran is an sole proprietor health care provider with primary practice located at 96 Danbury Rd , Ridgefield CT 06877-4069. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Anderson, Mark Doran can be contacted via phone (203) 438-0874.

Contact Information

Primary practice address
96 Danbury Rd Ridgefield CT 06877-4069
Phone: (203) 438-0874
Fax: (203) 438-5986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X CT027066 Connecticut

Profile Details

NPI number 1679640866
LBN Legal business name Anderson, Mark Doran
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Nov 18th, 2011 - about 15 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 1679640866 NPPES
Connecticut Other 010027066CT01 BCBS-CT
Connecticut Other ZP138 BCBS-CT
Connecticut Other 774197 BCBS-CT
Connecticut Other 1237318 BCBS-CT
Connecticut MEDICAID 001270669 BCBS-CT

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