Healthcare Provider Details

I. General information

NPI: 1699336446
Provider Name (Legal Business Name): EDWARD FRANK HURTTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 01/09/2023
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV IM HOSPITALIST
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8058
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-1700
  • Fax: 314-362-9878
Mailing address:
  • Phone: 314-362-1700
  • Fax: 314-362-9878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2021009887
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2021009887
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: