Anderson, Tarek
Anderson, Tarek is an sole proprietor health care provider with primary practice located at 4605 Maccorkle Ave Sw , South Charleston WV 25309-1311. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Anderson, Tarek can be contacted via phone (304) 346-9400.Contact Information
Primary practice address
4605 Maccorkle Ave Sw
South Charleston WV 25309-1311
Phone: (304) 346-9400
Fax: (304) 345-7320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 18922 | West Virginia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35065363 | Ohio |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 18922 | West Virginia |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 35065363 | Ohio |
Profile Details
| NPI number | 1841365640 |
|---|---|
| LBN Legal business name | Anderson, Tarek |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2006 |
| Last updated | May 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841365640 | NPPES |
| West Virginia | Other | 001723812 | MTN ST BCBS |
| West Virginia | MEDICAID | 0110693000 | MTN ST BCBS |
| West Virginia | Other | 3607462003 | MTN ST BCBS |
| West Virginia | Other | 4505652 | MTN ST BCBS |
| West Virginia | MEDICAID | 64103021 | MTN ST BCBS |
| West Virginia | Other | W45031 | MTN ST BCBS |
| West Virginia | MEDICAID | 0933682 | MTN ST BCBS |
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