Anderson, Mark W.

Anderson, Mark W. is an individual health care provider with primary practice located at 1215 Se 7Th Ave , Grand Rapids MN 55744-4201. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Anderson, Mark W. can be contacted via phone (218) 327-1105.

Contact Information

Primary practice address
1215 Se 7Th Ave Grand Rapids MN 55744-4201
Phone: (218) 327-1105
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 302045 Minnesota

Profile Details

NPI number 1225215122
LBN Legal business name Anderson, Mark W.
Credentials LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2008
Last updated Jan 23rd, 2008 - about 18 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 1225215122 NPPES
Minnesota Other 84-10374 UBH
Minnesota Other 1021875 UBH
Minnesota Other 8199PNO UBH

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