Provider Demographics
NPI:1275665390
Name:BRIAN A. ANDREWS, MD, LLC
Entity Type:Organization
Organization Name:BRIAN A. ANDREWS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-561-2229
Mailing Address - Street 1:300 MEDICAL PLZ
Mailing Address - Street 2:SUITE 221
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1481
Mailing Address - Country:US
Mailing Address - Phone:636-561-2229
Mailing Address - Fax:636-625-5288
Practice Address - Street 1:300 MEDICAL PLZ
Practice Address - Street 2:SUITE 221
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1481
Practice Address - Country:US
Practice Address - Phone:636-561-2229
Practice Address - Fax:636-625-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6E67261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty