Provider Demographics
NPI:1770708554
Name:ANDERSON, SAMUEL DEE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DEE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 603484
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3484
Mailing Address - Country:US
Mailing Address - Phone:803-765-1838
Mailing Address - Fax:803-765-1732
Practice Address - Street 1:2420 CAMINO RAMON
Practice Address - Street 2:STE. 270
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4385
Practice Address - Country:US
Practice Address - Phone:925-543-0141
Practice Address - Fax:925-543-0145
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA98380207R00000X, 207L00000X
MA232721207L00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine