IndividualActive
Bryan Anderson, PAC
NPI 1023417581 · Surgical Physician Assistant · Grand Rapids, MI
Provider details
- NPI number
- 1023417581
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- License
- 5601007077 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
221 Michigan St Ne Ste 300
Grand Rapids, MI 49503-2537
Phone: (616) 459-7258
Fax: (616) 459-5215
Approximate (ZIP-level) locationGet directions
Mailing address
100 Michigan St Ne
Grand Rapids, MI 49503-2560
Registry dates
- Enumerated
- 2014-08-20
- Last updated
- 2022-03-09
- Certified
- 2022-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.