DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. CHARLES W ANDERSON, MEDICAL DOCTOR

Deactivated

DR. CHARLES W ANDERSON, MEDICAL DOCTOR is a Pediatrics healthcare provider located in TAOS, New Mexico. NPI 1164480133 is deactivated in the NPPES registry. Verify at CMS.

Pediatrics · TAOS, NM

This NPI has been deactivated. The record was deactivated on July 17, 2007. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1164480133
Provider Type
Individual
Gender
Male
NPI Issued
May 1, 2006 (1.2103825136612 yrs)
Last Updated
Aug 31, 2007
Deactivated
Jul 17, 2007
License
64-23 (NM)

Practice Information

Address
123 CRUZ ALTA
TAOS, NM, 875716279
Browse NM providers · Browse ZIP 87571
Phone
5057588651
Fax
5057587811
Primary Specialty
Pediatrics
208000000X

Other Pediatrics Providers in TAOS, NM

Name Credential NPI
DR. RICHARD MICHAEL REMBECKI MD, PHD 1003884792
SYLVIA FERNANDEZ VILLARREAL MD 1740248756
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.