Healthcare Provider Details
I. General information
NPI: 1013666494
Provider Name (Legal Business Name): JARETT D ANDERSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/22/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3708 5TH AVE STE 500
PITTSBURGH PA
15213-3427
US
IV. Provider business mailing address
2002 HEMLOCK LN
MARS PA
16046-7201
US
V. Phone/Fax
- Phone: 800-533-8762
- Fax:
- Phone: 801-656-7069
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: