Provider Demographics
NPI:1538974522
Name:ANDERSON, DARWIN EUGENE
Entity type:Individual
Prefix:
First Name:DARWIN
Middle Name:EUGENE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10920 CRESCENT MOON PL
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68527-9726
Mailing Address - Country:US
Mailing Address - Phone:402-730-2373
Mailing Address - Fax:
Practice Address - Street 1:10920 CRESCENT MOON PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68527-9726
Practice Address - Country:US
Practice Address - Phone:402-730-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor