Healthcare Provider Details

I. General information

NPI: 1083647556
Provider Name (Legal Business Name): CINDY C BITTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

13120 FIRTREE CT
SAINT LOUIS MO
63146-1811
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-5225
  • Fax: 314-991-0943
Mailing address:
  • Phone: 314-469-0622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number111225
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: