Provider Demographics
NPI:1194997320
Name:ORTINAU, CYNTHIA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MARIE
Last Name:ORTINAU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-2683
Mailing Address - Fax:314-454-4633
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED NEWBORN MEDICINE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2683
Practice Address - Fax:314-454-4633
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016027760208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205655905Medicaid