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NPI Code Detail

MEDICARE: DR. JOSEPH CARL WITTMANN, JR. M.D.

MEDICARE: DR. JOSEPH CARL WITTMANN, JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician207649NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104820026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH CARL WITTMANN, JR. M.D.
Provider Business Mailing Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-807-0848
Provider Business Practice Location Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-807-0848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 11/04/2014

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