Provider Demographics
NPI:1831574326
Name:WYREBEK, RITA (MD MS)
Entity type:Individual
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First Name:RITA
Middle Name:
Last Name:WYREBEK
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Gender:F
Credentials:MD MS
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Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:DIVISION OF NEONATOLOGY
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104
Mailing Address - Country:US
Mailing Address - Phone:314-577-5642
Mailing Address - Fax:314-268-6410
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:DIVISION OF NEONATOLOGY
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104
Practice Address - Country:US
Practice Address - Phone:314-577-5642
Practice Address - Fax:314-268-6410
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2022-04-18
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Provider Licenses
StateLicense IDTaxonomies
MO20220057552080N0001X
FLME1407052080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine