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General NPI Number Information
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NPI Number | 1720181167
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Entity Type | Individual
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Provider Name | JOHN WILLIAM WITTENBORN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 127 WAMSUTTA MILL RD STE D
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City | MORGANTON
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State | NC
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Zip | 28655-5523
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Country | US
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Telephone | 828-430-3511
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Fax | 828-368-4303
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Provider Business Mailing Address
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Address Line | PO BOX 120590
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City | NEWPORT NEWS
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State | VA
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Zip | 23612-0590
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Country | US
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Telephone | 757-867-6102
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Fax | 757-867-6588
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 200000669
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | TM203
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 200000669
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License Number State | NC
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