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NPI 1811950769

NPI 1811950769 : CHRISTOPHER JACOB WITKE MD : HICKORY, NC

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General NPI Number Information
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    NPI Number           |    1811950769
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER JACOB WITKE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/11/2006
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    Last Update Date     |    03/15/2010
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Provider Practice Location Address
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    Address Line         |    221 13TH AVENUE PL NW 
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    City                 |    HICKORY
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    State                |    NC
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    Zip                  |    28601-2596
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    Country              |    US
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    Telephone            |    828-324-1699
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    Fax                  |    828-324-0281
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Provider Business Mailing Address
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    Address Line         |    221 13TH AVENUE PL NW 
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    City                 |    HICKORY
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    State                |    NC
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    Zip                  |    28601-2596
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    Country              |    US
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    Telephone            |    828-324-1699
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    Fax                  |    828-324-0281
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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       |    45384-020
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    License Number State |    WI
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