Derek Steven Anderson, DC | |
14413 Excelsior Blvd, Minnetonka, MN 55345-5821 | |
(952) 746-1506 | |
(952) 746-1508 |
Full Name | Derek Steven Anderson |
---|---|
Gender | Male |
Speciality | Chiropractic |
Experience | 15 Years |
Location | 14413 Excelsior Blvd, Minnetonka, Minnesota |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770884546 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 31664 (California) | Secondary |
111N00000X | Chiropractor | 5624 (Minnesota) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Healthsource Of Minnetonka Llc | 6901114032 | 2 |
Provider Name | Healthsource Of Minnetonka Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1164899795 PECOS PAC ID: 6901114032 Enrollment ID: O20151008002746 |
Mailing Address | Practice Location Address |
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Derek Steven Anderson, DC 14413 Excelsior Blvd, Minnetonka, MN 55345-5821 Ph: (952) 746-1506 | Derek Steven Anderson, DC 14413 Excelsior Blvd, Minnetonka, MN 55345-5821 Ph: (952) 746-1506 |
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