Provider Demographics
NPI:1528250396
Name:ANDERSON, PAUL S (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:128 PEACHTREE LN STE B
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6783
Mailing Address - Country:US
Mailing Address - Phone:336-998-3396
Mailing Address - Fax:336-998-2889
Practice Address - Street 1:128 PEACHTREE LN STE B
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-6783
Practice Address - Country:US
Practice Address - Phone:336-998-3396
Practice Address - Fax:336-998-2889
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY245659207L00000X
NC2013-00140207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology