Individual
DR. BRIAN N. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
16696
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
SC16696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080160922
MEDICARE RR
SC
05
—
166965
—
SC
01
—
571073118
TAX ID
SC
Enumeration date
03/08/2006
Last updated
06/11/2021
Update your record
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