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General NPI Number Information
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NPI Number | 1356384382
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Entity Type | Individual
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Provider Name | ELVIN D WITMER MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 571 TERRACE BLVD
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City | DEPEW
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State | NY
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Zip | 14043-3610
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Country | US
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Telephone | 716-683-4196
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Fax | 716-646-0763
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Provider Business Mailing Address
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Address Line | 571 TERRACE BLVD
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City | DEPEW
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State | NY
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Zip | 14043-3610
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Country | US
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Telephone | 716-683-4196
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Fax | 716-646-0763
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2104211
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License Number State | NY
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