NPI 1023569241

Michael Anderson, PA

Practitioner Physician Assistant Provo, UT

Practice location

Address: 1055 N 500 W STE 101, Provo, UT 84604-3305
Phone: (801) 373-4366
Fax: (801) 418-0941
Mailing address: PO Box 27128 Attn: Credentialing, Salt Lake City, UT 84127-0128

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 10117275-1206 (UT)

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Registry record

NPI: 1023569241
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Oct 2016
Record last updated: 7 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.