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Contact Information

PETER J ANDERSON, MD
4804 S STATE ROUTE 159 STE 10
GLEN CARBON, IL62034-1904
 Phone: 618-391-5080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PETER J ANDERSON · (Male)

NPI # 1548245848
Status Active
Credentials MD
Entity Individual
Enumeration date 12/08/2005
Last updated 08/28/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036079727
  • IL Medicaid 036079727
Hospital affiliation(s)
  • ANDERSON HOSPITAL - (Acute Care)
    6800 STATE ROUTE 162
    MARYVILLE, IL 62062
  • GATEWAY REGIONAL MEDICAL CENTER - (Acute Care)
    2100 MADISON AVENUE
    GRANITE CITY, IL 62040
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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