Individual provider · NPI-1

Jeffrey B Andersen, MD

Family Medicine · Fargo, ND

NPI number1184701856
StatusActive
Last updated in NPPESDec 23, 2020

Details

NPI
1184701856
Entity type
Individual (NPI-1)
Name
Jeffrey B Andersen
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Nov 1, 2006
Certification date
Dec 23, 2020
Last updated
Dec 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine10297NDYes
207Q00000X Family Medicine52145MN

Practice location

2400 32nd Ave S
Fargo, ND 58103-5800

Phone 701-234-2000

Mailing address

Po Box 5074
Sioux Falls, SD 57117-5074

Other practice locations

1245 Washington Ave
Detroit Lakes, MN 56501-3905

Phone 218-846-2000

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