Matthew Anderson, M.D. Obstetrics and Gynecology, P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

46328 Issued in MN

Legal business name

MATTHEW ANDERSON, M.D. OBSTETRICS AND GYNECOLOGY, P.A.

Practice address

4465 White Bear Pkwy
Suite 2
White Bear Lake, MN 55110-7623

Phone

(651) 653-0062

Fax

(651) 653-0288

NPI assigned

Jul 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Matthew W Anderson, M.D.

Title

President

Phone

(651) 653-0062

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1063865772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PKWY",
            "address_2": "SUITE 2",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551107623",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PKWY",
            "address_2": "SUITE 2",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551107623",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW ANDERSON, M.D. OBSTETRICS AND GYNECOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-653-0062",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "46328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy A. Marihart, D.C.
• Emmaline Maring
• Robert John Marolt, D.D.S.
• Rylee Ann Maruska
• Mia Rose Massaro
• Lori Matthews, NCTMB
• Zachary May
• Cherida Irene McCall, CNM
• Amanda Leigh McCarthy, MOTR/L
• Shannon McCarty, DC

• Clinic/Center in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.