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NPI Code Detail

MEDICARE: DR. PETER H WITTENBERG MD

MEDICARE:  DR. PETER H WITTENBERG  MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician22866NC

General Provider Information

NPI Number : 1194726612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER H WITTENBERG MD
Provider Business Mailing Address
First Line : 1760 COUNTRY CLUB DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-0220
Country : US
Telephone Number : 704-834-2851
Fax Number : 704-834-2815
Provider Business Practice Location Address
First Line : 2525 COURT DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2140
Country : US
Telephone Number : 704-834-2851
Fax Number : 704-834-2815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ DR. PETER H WITTENBERG MD” Practice Location

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