Michael Leslie Anderson, MD
Individual provider Active NPI Internal Medicine Physician · Minneapolis, MN
NPI 1811095508 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811095508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 24939 (MN)
- Practice address
- 1 Veterans Drive
Minneapolis, MN 55417-9969 - Phone
- (612) 467-1100
- Fax
- (612) 467-1913
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160303000683 | MN | Order and Referring Only - Internal Medicine |
9133154008 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24939 | MN | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 24939 | MN | Yes |
Addresses
Primary practice location
1 Veterans Drive
Minneapolis, MN 55417-9969
Mailing address
4741 Burr Oak St
Eagan, MN 55122-3321
Phone (651) 895-1171
Other providers in Minneapolis, MN
- Maria Anderson
- Martha Mitchell Anderson
- Mary L Anderson
- Megan Catherine Anderson
- Michael Anderson
- Michele Anderson
- Michelle Dione Du Four Anderson
- Michelle Joy Anderson
- Michelle Miyoko Anderson
- Molly Marie Anderson
All providers in Minneapolis, MN · Internal 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.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.