IndividualActive
Bradley Anderson, M.D.
NPI 1124086186 · Pediatrics Physician · Provo, UT
Provider details
- NPI number
- 1124086186
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 5579883-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1355 N University Ave
#210
Provo, UT 84604-2721
Phone: (801) 373-8930
Fax: (801) 377-6811
Approximate (ZIP-level) locationGet directions
Mailing address
1355 N University Ave
Provo, UT 84604-2721
Registry dates
- Enumerated
- 2006-05-01
- Last updated
- 2011-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.