Mark D Wittry
Nuclear Medicine Specialist Internist - Cardiovascular Disease
615 S New Ballas Rd Dept Of Nuclear Medicine
Saint Louis
, Missouri 63141-8221
Mark D Wittry
Nuclear Medicine Specialist Internist - Cardiovascular Disease
615 S New Ballas Rd Dept Of Nuclear Medicine
Saint Louis
, Missouri 63141-8221
(314) 991-8206
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Nuclear Medicine Specialist
Languages spoken
- English
Location
First Address
- Mark D Wittry
- 11475 Olde Cabin Rd Suite 200
- Saint Louis, MO
- Zip : 63141-7128
- Fax : (314) 991-8206
- Phone : (314) 991-8200
Second Address
- Mark D Wittry
- 615 S New Ballas Rd Dept Of Nuclear Medicine
- Saint Louis, MO
- Zip : 63141-8221
- Fax : (314) 251-4286
- Phone : (314) 251-6465
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | R5F02 | MO |
| N | 207U00000X | Nuclear Medicine Specialist | 036069181 | IL |
| Y | 207U00000X | Nuclear Medicine Specialist | R5F02 | MO |
National Provider Identifier
| NPI | 1497721088 |
|---|---|
| Provider Name | Mark D Wittry |
| First Address | Saint Louis, MO 63141-7128 |
| Second Address | Saint Louis, MO 63141-8221 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/02/2006 |
| Last Update Date | 22/02/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 202885919 | (05) | MO |
| E04262 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.