Individual provider · NPI-1

Michael Alex Anderson, Student

Anesthesiologist Assistant · Cincinnati, OH

NPI number1285302489
StatusActive
Last updated in NPPESSep 1, 2021

Details

NPI
1285302489
Entity type
Individual (NPI-1)
Name
Michael Alex Anderson
Credential
Student
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 1, 2021
Certification date
Aug 16, 2021
Last updated
Sep 1, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367H00000X Anesthesiologist Assistant67.000421OHYes

Practice location

2139 Auburn Ave
Cincinnati, OH 45219-2906

Phone 513-348-8567

Mailing address

6829 Summer Stone Ct
Liberty Twp, OH 45011-6401

Phone 513-348-8567

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