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General NPI Number Information
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NPI Number | 1700868643
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Entity Type | Individual
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Provider Name | LEE A WITTENBERG DPM
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 05/13/2023
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Provider Practice Location Address
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Address Line | 2901 N TENAYA WAY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89128-1404
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Country | US
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Telephone | 702-362-2622
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Fax | 702-362-0422
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Provider Business Mailing Address
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Address Line | 2901 N TENAYA WAY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89128-1404
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Country | US
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Telephone | 702-362-2622
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Fax | 702-362-0422
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2301
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2949
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0607
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License Number State | NV
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