Basic Information
| Provider Information | |||||||||
| NPI: | 1346334893 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BITTINGER | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1385 STONE CHURCH RD | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260037464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042330505 | ||||||||
| FaxNumber: | 3042330505 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 ORRS LN | ||||||||
| Address2: | |||||||||
| City: | TRIADELPHIA | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260591455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045479197 | ||||||||
| FaxNumber: | 3045479198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 05/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A0401X | 1105 | WV | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 363A00000X | 01105 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.