MEDICARE: DAVID H WITT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	033368	CT
2	207RH0003X	Hematology & Oncology Physician	033368	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487652665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H WITT M.D.

Provider Business Mailing Address
First Line	:	5520 PARK AVE
Second Line	:	STE 203
City	:	TRUMBULL
State	:	CT
Zip	:	06611-3463
Country	:	US
Telephone Number	:	203-334-7400
Fax Number	:	203-338-0455

Provider Business Practice Location Address
First Line	:	5520 PARK AVE
Second Line	:	STE 203
City	:	TRUMBULL
State	:	CT
Zip	:	06611-3463
Country	:	US
Telephone Number	:	203-334-7400
Fax Number	:	203-338-0455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2014

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Directions to “ DAVID H WITT M.D.” Practice Location

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