James Lee Anderson, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Duluth, MN
NPI 1275657348 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275657348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 25560 (MN)
- Practice address
- 707 Ridgewood Rd
Duluth, MN 55804-1732 - Phone
- (218) 724-7646
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25560 | MN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 25560 | MN | Yes |
Addresses
Primary practice location
707 Ridgewood Rd
Duluth, MN 55804-1732
Mailing address
707 Ridgewood Rd
Duluth, MN 55804-1732
Phone (218) 724-7646
Other providers in Duluth, MN
- Gregg David Anderson
- Gregory T Anderson
- Ian Anderson
- Ida Anderson
- Isabelle Anderson
- Kaylie Anderson
- Kimberly Ann Anderson
- Krista Anderson
- Kristen Lee Anderson
- Kristina Kay Anderson
All providers in Duluth, MN · Pediatric Adolescent Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.