NPI 1407847833 · live from the CMS NPI Registry
Ryan W Anderson, PA-C
Physician Assistant, Medical in Charleston, WV. National Provider Identifier 1407847833, active.
NPI record
| NPI | 1407847833 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 3701 Maccorkle Ave Se, Charleston, WV 25304 |
| Practice phone | 304-442-5151 |
| Mailing address | 401 6th Ave, Montgomery, WV 25136 |
| Enumerated | November 3, 2005 |
| Last updated | December 13, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 01148 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.