Provider Demographics
NPI:1679275721
Name:ANDERSON, MICHAEL STEVEN (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVEN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 BEACON HILL RD STE 160
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4441
Mailing Address - Country:US
Mailing Address - Phone:614-544-1837
Mailing Address - Fax:614-544-2816
Practice Address - Street 1:5131 BEACON HILL RD STE 160
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4441
Practice Address - Country:US
Practice Address - Phone:614-544-1837
Practice Address - Fax:614-544-2816
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program