MEDICARE: SARAH CHITTUM

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	237700000X	Hearing Instrument Specialist	80519	TX
2	237600000X	Audiologist-Hearing Aid Fitter		TX

General Provider Information

NPI Number	:	1730688722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH CHITTUM

Provider Business Mailing Address
First Line	:	6700 WASHINGTON AVE S
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3405
Country	:	US
Telephone Number	:	612-351-1529
Fax Number	:

Provider Business Practice Location Address
First Line	:	6199 CENTRAL CITY BLVD STE 122
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-3818
Country	:	US
Telephone Number	:	409-765-5500
Fax Number	:	409-744-8508

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

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	02/27/2019

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Directions to “ SARAH CHITTUM ” Practice Location

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