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Dana Gabriela Mazuru-Witten

Radiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as DANA MAZURU WITTEN.

Based on the most recent information from CMS, provider Dana Gabriela Mazuru-Witten is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1649386327
Provider Type
Individual
Full Name
Mazuru-Witten, Dana Gabriela
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
8/22/2006
Last Updated
9/15/2022

Contact Information

Practice Location

1 Hospital Dr, Columbia, MO 65212-0001

(573) 882-1161

(573) 884-8876

Mailing Location

PO Box 843966, Kansas City, MO 64184-3966

(573) 884-3300

(573) 884-0943

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 2005024095 Missouri

Provider Identifiers

ID	Description	Issuer
ID 204454508	Description Medicaid	Issuer Unlisted Missouri

Dana Gabriela Mazuru-Witten

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Stensby, James Derek

Mcnaul, David Wayne

Churchill, Robert J

Seibert, Morgan Lynn

Silva, Philip L

Altes, Talissa Ann

Kenkel, Brian Joseph

Hamid, Aws S

Aro, Michael Rantiolu

Cleek, John