Provider Demographics
NPI:1689666984
Name:ANDERS, DAVID LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:ANDERS
Suffix:
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 1:101 MCWILLIAMS DR.
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:770-487-0808
Mailing Address - Fax:770-487-0857
Practice Address - Street 1:101 MCWILLIAMS DR.
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:770-487-0808
Practice Address - Fax:770-487-0857
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029133207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582522721OtherTAX IDENTIFICATION NUMBER
GA11BDRNSMedicare ID - Type Unspecified
GAD39292Medicare UPIN