Anderson, Wayne L

Anderson, Wayne L is an individual health care provider with primary practice located at 1213 15Th Ave W Suite 200, Williston ND 58801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Anderson, Wayne L can be contacted via phone (701) 572-4003.

Contact Information

Primary practice address
1213 15Th Ave W Suite 200 Williston ND 58801
Phone: (701) 572-4003
Fax: (701) 572-4007
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4768 North Dakota

Profile Details

NPI number 1053417840
LBN Legal business name Anderson, Wayne L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Oct 24th, 2012 - about 14 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 1053417840 NPPES
North Dakota Other 20537 BLUE CROSS
North Dakota MEDICAID 0040157 BLUE CROSS
North Dakota MEDICAID 17987 BLUE CROSS

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