Ronald Warren Anderson, M.D., PH.D.
Individual provider Active NPI Internal Medicine Physician · Blair, NE
NPI 1376604231 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376604231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 16664 (NE)
- Practice address
- 407 S 19TH St
Blair, NE 68008-1907 - Phone
- (402) 426-2210
- Fax
- (402) 426-2235
- NPI assigned
- Dec 13, 2006
- 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)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16664 | NE | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16664 | NE | Yes |
Addresses
Primary practice location
407 S 19TH St
Blair, NE 68008-1907
Mailing address
231 N 97TH CT
Omaha, NE 68114-2398
Phone (402) 691-0416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30200 | Other | NE | BCBS |
| 10025285200 | Medicaid | NE |
Other providers in Blair, NE
- Kevin A Almquist
- Brenda Lea Anderson
- Cheryl Anderson
- Bailie Appel
- Kay Lynn Arispe
- Lynda D Arnold
- Assisted Living Concepts Inc
- Keiley Audiss
All providers in Blair, NE · Internal Medicine Physician in Nebraska
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.