Wittry, Mark D
Wittry, Mark D is an individual health care provider with primary practice located at 615 S New Ballas Rd Dept Of Nuclear Medicine, Saint Louis MO 63141-8221. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy. Allopathic & Osteopathic Physicians / Nuclear Medicine is his primary health care specialty. Wittry, Mark D can be contacted via phone (314) 251-6465.Contact Information
Primary practice address
615 S New Ballas Rd Dept Of Nuclear Medicine
Saint Louis MO 63141-8221
Phone: (314) 251-6465
Fax: (314) 251-4286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | R5F02 | Missouri |
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | R5F02 | Missouri |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | R5F02 | Missouri |
| Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy | 207UN0902X | R5F02 | Missouri |
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | 036069181 | Illinois |
Profile Details
| NPI number | 1497721088 |
|---|---|
| LBN Legal business name | Wittry, Mark D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2006 |
| Last updated | Feb 22nd, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497721088 | NPPES |
| Missouri | MEDICAID | 202885919 |
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