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NPI Code Detail

MEDICARE: DR. MARY BETH CHITWOOD MD

MEDICARE:  DR. MARY BETH CHITWOOD  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2002014087MO

General Provider Information

NPI Number : 1376504621
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY BETH CHITWOOD MD
Provider Business Mailing Address
First Line : 3619 RICHARDSON SQUARE DR
Second Line : SUITE 170
City : ARNOLD
State : MO
Zip : 63010
Country : US
Telephone Number : 636-717-6776
Fax Number : 314-525-4055
Provider Business Practice Location Address
First Line : 3619 RICHARDSON SQUARE DR
Second Line : SUITE 170
City : ARNOLD
State : MO
Zip : 63010
Country : US
Telephone Number : 636-717-6776
Fax Number : 314-525-4055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 08/27/2013

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Directions to “ DR. MARY BETH CHITWOOD MD” Practice Location

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