Bryan Anderson, PA-C
Individual provider Active NPI Physician Assistant · Fort Stewart, GA
NPI 1902389588 · NPPES record last updated Dec 21, 2023
Key facts
- NPI
- 1902389588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1162522 (GA)
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314-5641 - Phone
- (912) 315-8354
- NPI assigned
- Sep 10, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1162522 | GA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1162522 | GA | Yes |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 315-8354
Other providers in Fort Stewart, GA
- Alvaro Alvarado
- Valeria Janeth Alvarado
- Bonita Wonziel Alvarez
- Jessica Amico
- Steven Mark Amster
- Hurty Lee Anderson III
- Isabella Anderson
- Jayson Malcolm Anderson
- William R. Anderson
- Douglas Andrews
All providers in Fort Stewart, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.