Provider Demographics
NPI:1154611838
Name:ANDERSON, WILLIAM STEPHEN (PA-C)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:ANDERSON
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ONEIL BLVD
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4250
Mailing Address - Country:US
Mailing Address - Phone:508-342-1103
Mailing Address - Fax:508-342-1945
Practice Address - Street 1:100 ONEIL BLVD
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4250
Practice Address - Country:US
Practice Address - Phone:508-342-1103
Practice Address - Fax:508-342-1945
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical