Provider Demographics
NPI:1245248210
Name:ANDERSON, CLAUDETTE ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:ELIZABETH
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 1:2701 KIRKWOOD HWY STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-4911
Mailing Address - Country:US
Mailing Address - Phone:302-485-1600
Mailing Address - Fax:
Practice Address - Street 1:2701 KIRKWOOD HWY STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4911
Practice Address - Country:US
Practice Address - Phone:302-485-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143588207V00000X
DEDR0025570207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00704229Medicaid
NY00704229Medicaid
NY30D382Medicare PIN