Individual
DR. TRINA J BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 PROGRESS POINT PKWY STE 100, O FALLON, MO 63368-2207
(636) 344-2213
Mailing address
20 PROGRESS POINT PKWY STE 100, O FALLON, MO 63368-2207
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
119707
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122086
BLUE CROSS BLUE SHIELD ID
MO
Enumeration date
02/15/2007
Last updated
02/13/2023
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