Individual
ALAN BIRTWISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 845-5077
Mailing address
13253 ROMANY WAY CT, SAINT LOUIS, MO 63131-1610
(314) 652-4100
(314) 845-5077
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2004001430
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209101708
—
MO
Enumeration date
04/13/2006
Last updated
03/28/2024
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