IndividualActive
Charles Anderson, MEDICAL DOCTOR
NPI 1164480133 · Pediatrics Physician · Taos, NM
Provider details
- NPI number
- 1164480133
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MEDICAL DOCTOR
- Sex
- Male
- Sole proprietor
- No
- License
- 64-23 (NM)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
123 Cruz Alta
Taos, NM 87571-6279
Phone: (505) 758-8651
Fax: (505) 758-7811
Approximate (ZIP-level) locationGet directions
Mailing address
123 Cruz Alta
Taos, NM 87571-6279
Registry dates
- Enumerated
- 2006-05-01
- Last updated
- 2007-08-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.