Healthcare Provider Details

I. General information

NPI: 1437107257
Provider Name (Legal Business Name): DOUGLAS A WITTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 SAXON BLVD
ORANGE CITY FL
32763-8468
US

IV. Provider business mailing address

606 VICTORIA HILLS DR
DELAND FL
32724-8828
US

V. Phone/Fax

Practice location:
  • Phone: 931-237-6597
  • Fax:
Mailing address:
  • Phone: 931-237-6597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 69403
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: