Provider Demographics
NPI:1770625972
Name:ANDERSON, STEPHEN DANIEL II (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DANIEL
Last Name:ANDERSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE VANTAGE WAY
Mailing Address - Street 2:SUITE B-240 MIDDLE TENNESSEE EMERGENCY PHYSICIAN PC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 NORTH HIGHLAND AVENUE
Practice Address - Street 2:MIDDLE TENNESSEE MEDICAL CENTER
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:502-384-5009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1147207P00000X
TN43510207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine