Provider Demographics
NPI:1700850195
Name:ANDERSEN, WILLIAM KRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KRISTIAN
Last Name:ANDERSEN
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 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:919-467-4992
Mailing Address - Fax:919-481-9607
Practice Address - Street 1:1120 SE CARY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7413
Practice Address - Country:US
Practice Address - Phone:919-467-4992
Practice Address - Fax:919-481-9607
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600842207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNNF119L103OtherMEDICARE
NC11124OtherBCBS
NC1700850195Medicaid
NC2111516OtherUNITED HEALTHCARE
NC5406276OtherAETNA PPO
NC2076472OtherFIRST HEALTH
NC2350709OtherAETNA HMO
NC5406276OtherAETNA PPO