Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 004472 | MO |
NPI | 1548397482 |
---|---|
Provider Name | Dr. Sharon L. Fitelson |
First Address | Richmond Heights, MO 63117-1325 |
Second Address | Richmond Heights, MO 63117-1325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119539 | GHP PROVIDER # (01) | MO |
287406 | HEALTHLINK PROVIDER # (01) | MO |
628178 | UNITED HEALTHCARE PROV # (01) | MO |
6332 | BLUE CROSS PROVIDER # (01) | MO |
T43375 | (02) | MO |
T43375 | MERCY PROVIDER # (01) | MO |