Individual
NITA R. ENGINEER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1824
(732) 271-3543
Mailing address
PO BOX 3011, GILLETTE, WY 82717-3011
(307) 688-2600
(307) 685-3079
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11594A
WY
207L00000X
Anesthesiology Physician
22896
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
22896
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100613
PTAN MEDICARE
NJ
05
—
228961
—
SC
Enumeration date
03/23/2006
Last updated
01/29/2019
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