Provider Demographics
NPI:1972505212
Name:BITNER, ALAN FETZER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:FETZER
Last Name:BITNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102
Mailing Address - Country:US
Mailing Address - Phone:385-282-2750
Mailing Address - Fax:385-282-2751
Practice Address - Street 1:389 SOUTH 900 EAST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102
Practice Address - Country:US
Practice Address - Phone:385-282-2750
Practice Address - Fax:358-282-2751
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86-174921-1205207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F72889Medicare UPIN
UT000060335Medicare PIN