Individual provider · NPI-1

Dr. Shelly L Anderson, M.D.

Family Medicine · Plymouth, MN

NPI number1073594966
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1073594966
Entity type
Individual (NPI-1)
Name
Dr. Shelly L Anderson
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Nov 8, 2005
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine33473MNYes

Practice location

1495 Hwy 101 North
Plymouth, MN 55447

Phone 763-476-6776

Mailing address

5502 W Broadway Ave
Suite 200
Crystal, MN 55428-3508

Phone 763-287-6500 · Fax 763-287-6544

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