MR. Jeffrey Michael Ditter, NP
NPI #1508307190 in Lake St Louis, Missouri
Provider Information
- NPI Number
- 1508307190
- Entity Type
- Individual
- Name
- MR. Jeffrey Michael Ditter, NP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- NP
- Enumeration Date
- Mar 15, 2017
- Last Updated
- Jan 13, 2021
Practice Location
- Address
- 100 MEDICAL PLZ
- City
- Lake St Louis
- State
- Missouri
- ZIP Code
- 63367-1366
- Phone
- (636) 625-5200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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