Charles Leon Anderson Jr., MD
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Westwood, MA
NPI 1720072390 · NPPES record last updated Dec 9, 2019
Key facts
- NPI
- 1720072390
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- 75583 (MA)
- Practice address
- 127 University Ave
Westwood, MA 02090 - Phone
- (781) 686-1608
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75583 | MA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imed RX PC | Current |
Accepting new patients | |
| Dimock Community Health Center, Inc | Past |
Accepting new patients |
Locations
127 University Ave
Westwood, MA 02090
Phone (781) 686-1608
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 75583 | MA | Yes |
Addresses
Primary practice location
127 University Ave
Westwood, MA 02090
Mailing address
23 Craigie Ter
Newton, MA 02460-2106
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3127991 | Medicaid | MA |
Other providers in Westwood, MA
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- Abolhassan Amouzgar
- Anaesthesia Associates of Ma, PC
- Anaesthesia Associates of Massachusetts, PC
- Anaesthesia Associates of Massachusetts, PC
- Marc Andreani-Fabroni
- Arch Orthodontics, PC
- Gloria D Artis
- Matthew Ascione
- Jennifer Ashton
All providers in Westwood, MA · Neonatal-Perinatal Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2019. 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.