William Anderson, D.O.
Individual provider Active NPI Family Medicine Physician · Great Diamond Island, ME
NPI 1487841573 · NPPES record last updated Oct 2, 2007
Key facts
- NPI
- 1487841573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 902 (ME)
- Practice address
- 16F Diamond Cove
Great Diamond Island, ME 04109 - Phone
- (207) 766-5008
- Fax
- (207) 766-5008
- NPI assigned
- Oct 2, 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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902 | ME | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 902 | ME | Yes |
Addresses
Primary practice location
16F Diamond Cove
Great Diamond Island, ME 04109
Mailing address
16F Diamond St.
Portland, ME 04101-2516
Phone (207) 766-5008
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 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.