MEDICARE: DR. THOMAS A WITTMANN 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD026724E	PA
2	207RP1001X	Pulmonary Disease Physician	MD026724E	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1467429076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS A WITTMANN M.D.

Provider Business Mailing Address
First Line	:	4382 WINNERS CIR
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16506-6610
Country	:	US
Telephone Number	:	814-833-1451
Fax Number	:

Provider Business Practice Location Address
First Line	:	3580 PEACH ST
Second Line	:	SUITE 103A
City	:	ERIE
State	:	PA
Zip	:	16508-2776
Country	:	US
Telephone Number	:	814-864-4755
Fax Number	:	814-864-5430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	02/18/2010

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