# DR. BRENT R ANDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588670590
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | D51912 | MD | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | MD22000 | DC | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 02/14/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 456121000 | — | MD |