Healthcare Provider Details

I. General information

NPI: 1306023742
Provider Name (Legal Business Name): SCOTT ALLAN WITT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUKE UNIVERSITY MEDICAL CENTER DEPARTMENT OF PEDIATRICS DUMC BOX 3179
DURHAM NC
27710-0001
US

IV. Provider business mailing address

DUMC BOX 3179 DUKE UNIVERSITY MEDICAL CENTER DEPARTMENT OF PEDIATRICS
DURHAM NC
27710
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-1592
  • Fax: 919-681-6065
Mailing address:
  • Phone: 919-668-1592
  • Fax: 919-681-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number141864
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: