Healthcare Provider Details

I. General information

NPI: 1780704999
Provider Name (Legal Business Name): BRITTA MARGARET ANDERSON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28800 RYAN RD STE 120
WARREN MI
48092-4272
US

IV. Provider business mailing address

28800 RYAN RD STE 120
WARREN MI
48092-4272
US

V. Phone/Fax

Practice location:
  • Phone: 586-558-2860
  • Fax: 586-558-4624
Mailing address:
  • Phone: 586-558-2860
  • Fax: 586-558-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number5101016601
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: