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General NPI Number Information
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NPI Number | 1144884222
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Entity Type | Individual
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Provider Name | BRITT ANDERSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | DEPT. OF PSYCHOLOGY, UNIVERSITY OF WATERLOO 200 UNIVERSITY AVENUE WEST
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City | WATERLOO
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State | ONTARIO
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Zip | N2L3G1
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Country | CA
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Telephone | 519-888-4567
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT. OF PSYCHOLOGY, UNIVERSITY OF WATERLOO 200 UNIVERSITY AVENUE WEST
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City | WATERLOO
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State | ONTARIO
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Zip | N2L3G1
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 10451
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License Number State | RI
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