Provider Demographics
NPI:1326127473
Name:ANDREWS, BRIAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-579-3203
Mailing Address - Fax:
Practice Address - Street 1:3048 E BASELINE RD
Practice Address - Street 2:STE 120
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7286
Practice Address - Country:US
Practice Address - Phone:480-505-3276
Practice Address - Fax:480-505-3288
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ283166OtherMEDICARE
AZ288557Medicaid