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General NPI Number Information
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NPI Number | 1831707843
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Entity Type | Organization
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Legal Business Name | WITTING MEDICAL, LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 64 THOMAS JOHNSON DR
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City | FREDERICK
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State | MD
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Zip | 21702-4734
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Country | US
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Telephone | 571-214-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 64 THOMAS JOHNSON DR
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City | FREDERICK
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State | MD
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Zip | 21702-4734
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Country | US
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Telephone | 571-214-6550
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ERIC ALLELY
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Credential | M.D.
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Telephone | 571-214-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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