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NPI Code Detail

MEDICARE: MRS. LAURA LEE MATZKE BITTERMAN M.D.

MEDICARE: MRS. LAURA LEE MATZKE BITTERMAN 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
1207L00000XAnesthesiology Physician56990MN
2208VP0014XInterventional Pain Medicine Physician14790ND
3208VP0000XPain Medicine Physician14790ND

General Provider Information

NPI Number : 1952652992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA LEE MATZKE BITTERMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-6585
Fax Number :
Provider Business Practice Location Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2012
Last Update Date : 04/29/2022

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