Healthcare Provider Details

I. General information

NPI: 1710513510
Provider Name (Legal Business Name): DANIEL RITZ WITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 WALNUT ST STE 2
WELLESLEY MA
02481-2109
US

IV. Provider business mailing address

62 WALNUT ST STE 2
WELLESLEY HILLS MA
02481-2109
US

V. Phone/Fax

Practice location:
  • Phone: 857-678-3901
  • Fax: 857-314-6445
Mailing address:
  • Phone: 857-678-3901
  • Fax: 857-314-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1017832
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1017832
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: