Anderson, Mark Ian
Anderson, Mark Ian is an individual health care provider with primary practice located at 450 S Kitsap Blvd Ste 210 , Port Orchard WA 98366-3738. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Anderson, Mark Ian can be contacted via phone (360) 895-8950.Contact Information
Primary practice address
450 S Kitsap Blvd Ste 210
Port Orchard WA 98366-3738
Phone: (360) 895-8950
Fax: (360) 895-8980
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 01053155A | Indiana |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD60194935 | Washington |
Profile Details
| NPI number | 1215900303 |
|---|---|
| LBN Legal business name | Anderson, Mark Ian |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Nov 12th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215900303 | NPPES |
| Washington | MEDICAID | 2011203 |
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