Provider Demographics
NPI:1376528711
Name:ANDERSON, CYNTHIA (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2722
Mailing Address - Fax:717-851-3127
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:STE 202
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-851-2722
Practice Address - Fax:717-851-3127
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425151207V00000X, 207VM0101X
MDD0070729207VM0101X
IN01059746A207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA420528OtherUPMC
PA2982526OtherHIGHMARK BLUE SHIELD
MD038105501Medicaid
PA102858463Medicaid
PA308161EZ3Medicare PIN
PA102858463Medicaid
PA420528OtherUPMC
PA308161FLTMedicare PIN