Donald Robert Anderson, M.D.
Individual provider Active NPI Psychiatry Physician · Bend, OR
NPI 1922097807 · NPPES record last updated Mar 2, 2010
Key facts
- NPI
- 1922097807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- MD29374 (OR)
- Practice address
- 2115 NE Wyatt CT Ste 201
Bend, OR 97701-7680 - Phone
- (541) 647-5200
- Fax
- (541) 389-5459
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A81871 | CA | MD | Psychiatry Physician |
| MD29374 | OR | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A81871 | CA | |
| Psychiatry Physician | 2084P0800X | MD29374 | OR | Yes |
Addresses
Primary practice location
2115 NE Wyatt CT Ste 201
Bend, OR 97701-7680
Mailing address
2115 NE Wyatt CT Ste 201
Bend, OR 97701-7680
Phone (541) 647-5200
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2010. 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.