NPI 1194019406 · live from the CMS NPI Registry
Michael Anderson, D.O.
Emergency Medicine, Emergency Medical Services in Rexburg, ID. National Provider Identifier 1194019406, active.
NPI record
| NPI | 1194019406 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Emergency Medicine, Emergency Medical Services 207PE0004X |
| Practice location | 450 E Main St, Rexburg, ID 83440 |
| Practice phone | 208-356-3691 |
| Enumerated | June 3, 2011 |
| Last updated | April 2, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | ED0179A (WV) |
| Emergency Medicine, Emergency Medical Services primary | 207PE0004X | O-0885 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.