Individual
DR. DOUGLAS STEWART FITZWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 E 3RD ST, PORTAGEVILLE, MO 63873-1402
(573) 379-5467
(573) 379-5671
Mailing address
1008 N MAIN ST, SIKESTON, MO 63801-5044
(573) 472-7406
(573) 472-7475
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R8N02
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
R8N02
MO
208M00000X
Hospitalist Physician
R8N02
MO
Other
Enumeration date
10/26/2005
Last updated
08/20/2019
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