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Contact Information

KEVIN C ANDERSON, MD
100 NAVARRE PL STE 4440
SOUTH BEND, IN46601-1171
 Phone: 574-647-5300
 Fax: 574-647-5305
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KEVIN C ANDERSON · (Male)

NPI # 1427150796
Status Active
Credentials MD
Entity Individual
Enumeration date 09/05/2006
Last updated 12/30/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01079147A
  • IN Medicaid 300006370
Hospital affiliation(s)
  • PROVIDENCE HOSPITAL AND MEDICAL CENTERS - (Acute Care)
    16001 W NINE MILE RD
    SOUTHFIELD, MI 48075
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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