MEDICARE: MATTHEW N WITTE MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	5167	SD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00047548	OTHER	SD	RAILROAD MEDICARE

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

NPI Number	:	1548228141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW N WITTE MD

Provider Business Mailing Address
First Line	:	201 W 69TH ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2403
Country	:	US
Telephone Number	:	605-336-0635
Fax Number	:	605-336-7182

Provider Business Practice Location Address
First Line	:	201 W 69TH ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2403
Country	:	US
Telephone Number	:	605-336-0635
Fax Number	:	605-336-7182

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	02/01/2012

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax: