Provider Demographics
NPI:1558477711
Name:ANDERSON, MARGARET ROSE (MARGARET ANDERSON)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ROSE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MARGARET ANDERSON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TAMARADE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4344
Mailing Address - Country:US
Mailing Address - Phone:303-932-0594
Mailing Address - Fax:
Practice Address - Street 1:445 UNION BLVD
Practice Address - Street 2:202
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1237
Practice Address - Country:US
Practice Address - Phone:303-933-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO283182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COA63176Medicare UPIN
CO0382-1Medicare ID - Type Unspecified