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General NPI Number Information
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NPI Number | 1275665390
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Entity Type | Organization
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Legal Business Name | BRIAN A. ANDREWS, MD, LLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 MEDICAL PLZ SUITE 221
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1481
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Country | US
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Telephone | 636-561-2229
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Fax | 636-625-5288
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Provider Business Mailing Address
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Address Line | 300 MEDICAL PLZ SUITE 221
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1481
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Country | US
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Telephone | 636-561-2229
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Fax | 636-625-5288
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN ALLEN ANDREWS
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Credential | MD
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Telephone | 636-561-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | R6E67
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License Number State | MO
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