MARK D WITTRY


Address: 615 S New Ballas Rd, Dept of Nuclear Medicine, Saint Louis, MO 63141-8221
Phone: 3142516465

MARK D WITTRY (NPI# 1497721088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497721088
Entity Type Individual
Full Name MARK D WITTRY
Credential MD
Practice Address 615 S New Ballas Rd
Dept of Nuclear Medicine
Saint Louis
MO 63141-8221
Mailing Address 11475 Olde Cabin Rd
Suite 200
Saint Louis
MO 63141-7128
Practice Telephone 3142516465
Practice Fax Number 3142514286
Mailing Telephone 3149918200
Mailing Fax Number 3149918206
Enumeration Date 2006-02-24
Last Update Date 2016-02-22
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
R5F02 MO Allopathic & Osteopathic Physicians
N 207U00000X Nuclear Medicine 036069181 IL Allopathic & Osteopathic Physicians
Y 207U00000X Nuclear Medicine R5F02 MO Allopathic & Osteopathic Physicians
N 207UN0902X Nuclear Medicine
Specialization: Nuclear Imaging & Therapy
R5F02 MO Allopathic & Osteopathic Physicians
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
R5F02 MO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MO 202885919 05

Office Location

Street Address 615 S NEW BALLAS RD
DEPT OF NUCLEAR MEDICINE
City SAINT LOUIS
State MO
Zip Code 63141-8221

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780689182 Robert W Allen Anesthesiology 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2005-06-14
1033722061 Ashley Maull Nurse Practitioner 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-08-28
1508476367 Ryan Nathan Student in an Organized Health Care Education/Training Program 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-08-06
1992315857 Corey Weicht Nurse Practitioner 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-08-05
1063021905 Alexandria Colleen Grodie Nurse Practitioner 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-07-27
1396353892 Fahad Bin Tahir Internal Medicine 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-07-21
1588281307 Alexander Cai Dentist 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-06-26
1083231070 Lauren Gonzalez Anesthesiologist Assistant 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-06-25
1780200253 Matthew Davis Internal Medicine 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-06-22
1902422421 Megan Reidy Landis Family Medicine 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2020-06-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679102842 Noor Ramadan Pharmacist 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 2020-04-08
1497381206 Washington University Durable Medical Equipment & Medical Supplies 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 2020-03-13
1154956498 Ashleigh Clendenny Physician Assistant Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 2020-03-06
1801429410 Emili Lou Haley Registered Nurse 650 Maryville Drive, St Louis, MO 63141 2020-02-21
1629553110 Rebecca Kathleen Pike Social Worker West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 2018-10-01
1649756099 River City Sedation Associates, LLC Nurse Anesthetist, Certified Registered 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 2018-07-18
1205333952 Ear Care and Hearing of St. Louis Hearing Aid Equipment 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 2018-04-10
1659897486 Erin Goodman Physical Therapist 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 2017-08-14
1093230450 Center for Urologic Surgery LLC Clinic/Center 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 2017-08-07
1871016105 Jacob Farley Tanner Specialist/Technologist 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 2017-07-19
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Taxonomy Information

Taxonomy Code 207U00000X
Grouping Allopathic & Osteopathic Physicians
Classification Nuclear Medicine

Taxonomy Definition

A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack), early cancer detection and evaluation of the effect of tumor treatment, diagnosis of infection and inflammation anywhere in the body and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to bone
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Nuclear Medicine, 2007. http://www.abnm.org/. A doctor of osteopathy was able to obtain a Certificate of Added Qualifications in the field of Nuclear Medicine. The Certificate is NO longer offered.
- American Osteopathic Board of Nuclear Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Nuclear Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477890184 Syed Sertaj Akhtar Nuclear Medicine 1045 Pinegate Dr, Saint Louis, MO 63122-2409 2013-01-15
1740306067 Asif Moinuddin Nuclear Medicine 8985 S Swan Cir, Saint Louis, MO 63144-1717 2007-03-21
1902442650 Amir Iravani Tabrizipour Nuclear Medicine 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 2019-11-18
1942850078 Paul-robert Derenoncourt Nuclear Medicine 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 2019-09-20
1750728192 Malak Itani Nuclear Medicine 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 2013-05-24
1962750265 Rashmi Jain Nuclear Medicine 615 S New Ballas Rd, Dept of Nuclear Medicine/radiology, Saint Louis, MO 63141-8221 2012-08-17
1407118318 Michael S. Moritz Nuclear Medicine 615 S New Ballas Rd, Saint Louis, MO 63141 2012-06-15
1104132331 Garima Agrawal Nuclear Medicine 660 S Euclid Ave, Cmps Box 8131, Wash Univ-dept of Nuclear Medicine, Saint Louis, MO 63110-1010 2010-08-25
1154549459 St Louis University Nuclear Medicine 3635 Vista Ave, Saint Louis, MO 63110-2539 2007-04-23
1063506392 Farrokh Dehdashti Nuclear Medicine 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 2006-10-03
Find all providers in SAINT LOUIS

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City SAINT LOUIS
Zip Code 63141

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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