Provider Demographics
NPI:1306867833
Name:ANDERSON, STEPHEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:ANDERSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1000
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:95 SARGENT ST
Practice Address - Street 2:ROUTE 9
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9881
Practice Address - Country:US
Practice Address - Phone:413-323-7212
Practice Address - Fax:413-967-2524
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MA203189207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH36336Medicare UPIN