Provider Demographics
NPI:1528238326
Name:ALBERT B ANDERSON MD PA
Entity type:Organization
Organization Name:ALBERT B ANDERSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-252-6922
Mailing Address - Street 1:141 ASHELAND AVE
Mailing Address - Street 2:200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4047
Mailing Address - Country:US
Mailing Address - Phone:828-252-6922
Mailing Address - Fax:828-252-6989
Practice Address - Street 1:141 ASHELAND AVE
Practice Address - Street 2:200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4047
Practice Address - Country:US
Practice Address - Phone:828-252-6922
Practice Address - Fax:828-252-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27013332B00000X
NC200001536205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11092OtherBLUE CROSS BLUE SHIELD
NC8911092Medicaid
NC8911092Medicaid
NC11092OtherBLUE CROSS BLUE SHIELD
NC6243500001Medicare NSC