Mary Beth Anderson, D.O.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

5101011355 Issued in MI

Practice address

18756 Millar Rd
Clinton Township, MI 48036-2095

Phone

(586) 381-0177

Fax

(859) 987-7661

NPI assigned

Dec 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• S L Husain Hamzavi MD PC

  dba Hamzavi Dermatology

  • Dermatology Physician
  • Clinton TWP, MI
  • NPI 1407943962
  Medicare reassignment
• Midwest Center for Dermatology & Pathology, PLLC

  • Dermatopathology Physician
  • Clinton Township, MI
  • NPI 1003095084
  NPD
• Dermatology Specialists of Canton, PLLC

  • Dermatology Physician
  • Canton, MI
  • NPI 1003069014
  NPD (past)
• Timothy P. Baessler, DPM, PC

  • Foot & Ankle Surgery Podiatrist
  • Bloomfield Township, MI
  • NPI 1598060428
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457419160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18756 MILLAR RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362095",
            "telephone_number": "586-381-0177",
            "fax_number": "859-987-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18756 MILLAR RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362095",
            "telephone_number": "586-381-0177",
            "fax_number": "859-987-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARY BETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MI",
            "license": "5101011355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2155003214",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Rochelle Anderson, LLMSW
• Daija Anderson
• James B Anderson, MD
• Kaitlyn Yuling Anderson
• Kathryn Anderson, LPC
• Anesthesia Surgical Associates, PLLC
• Angel Wings Luxury Home Care Group LLC Dba Angel Wings Luxury Healthcare
• Ronald Cutia Angeles, PHYSICAL THERAPIST
• Peter A. Angelov, D.O.
• Jennifer Anton, LLMSW

• Dermatopathology (Pathology) Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Dermatopathology (Pathology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.