Provider Demographics
NPI:1831154244
Name:ANDERSON, DANIEL EDWARD (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:EDWARD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1771 TATE BLVD SE
Mailing Address - Street 2:STE 103
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-322-1128
Mailing Address - Fax:828-327-9631
Practice Address - Street 1:1771 TATE BLVD SE
Practice Address - Street 2:STE 103
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-322-1128
Practice Address - Fax:828-327-9631
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9500806207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911093Medicaid
NC2212412AMedicare PIN
F41116Medicare UPIN