Provider Demographics
NPI:1346334893
Name:BITTINGER, BETH L (PA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:L
Last Name:BITTINGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1385 STONE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-7464
Mailing Address - Country:US
Mailing Address - Phone:304-233-0505
Mailing Address - Fax:304-233-0505
Practice Address - Street 1:40 ORRS LN
Practice Address - Street 2:
Practice Address - City:TRIADELPHIA
Practice Address - State:WV
Practice Address - Zip Code:26059-1455
Practice Address - Country:US
Practice Address - Phone:304-547-9197
Practice Address - Fax:304-547-9198
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV11052084A0401X
WV01105363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVPA29131Medicare PIN
WVQ30551Medicare UPIN