MEDICARE: WILLIAM J WITTMAN 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	207R00000X	Internal Medicine Physician	54719	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00067055	OTHER	MA	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	6251	OTHER	MA	HARVARD PILGRIM
3	376898	OTHER	MA	PRIVATE HEALTHCARE SYSTEM
4	715096	OTHER	MA	TUFTS HEALTH PLAN
5	M18254	OTHER	MA	BLUE CROSS BLUE SHIELD
6	0402434	OTHER	MA	UNITED HEALTHCARE
7	3256423	OTHER	MA	AETNA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891798724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J WITTMAN M.D.

Provider Business Mailing Address
First Line	:	10 BRAMBLEBUSH PARK
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-2325
Country	:	US
Telephone Number	:	508-540-1046
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 BRAMBLEBUSH PARK
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-2325
Country	:	US
Telephone Number	:	508-540-1046
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/28/2010

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