Individual
BRYAN J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 W A ST STE G, MOSCOW, ID 83843-4902
(208) 883-1177
(208) 892-0170
Mailing address
PO BOX 8007, MOSCOW, ID 83843-0507
(208) 882-4511
(208) 883-6580
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7735
ID
Other
Enumeration date
12/14/2006
Last updated
07/19/2024
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