MEDICARE: ROBERT A. SCIORTINO M.D.

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
1	207X00000X	Orthopaedic Surgery Physician	R7J25	MO

General Provider Information

NPI Number	:	1639151517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A. SCIORTINO M.D.

Provider Business Mailing Address
First Line	:	660 MASON RIDGE CENTER DR STE 300
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8512
Country	:	US
Telephone Number	:	314-463-6950
Fax Number	:	314-996-7658

Provider Business Practice Location Address
First Line	:	9323 PHOENIX VILLAGE PKWY
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-4281
Country	:	US
Telephone Number	:	314-434-3240
Fax Number	:	314-434-6956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	04/12/2024

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