MEDICARE: DR. VENUS STELLA WITTENAUER DO

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	207Q00000X	Family Medicine Physician	34006914M	OH

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	:	1750375630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VENUS STELLA WITTENAUER DO

Provider Business Mailing Address
First Line	:	48462 BELL SCHOOL RD STE A
Second Line	:
City	:	EAST LIVERPOOL
State	:	OH
Zip	:	43920-9625
Country	:	US
Telephone Number	:	724-773-3404
Fax Number	:	724-770-7939

Provider Business Practice Location Address
First Line	:	48462 BELL SCHOOL RD STE A
Second Line	:
City	:	EAST LIVERPOOL
State	:	OH
Zip	:	43920-9625
Country	:	US
Telephone Number	:	724-773-3404
Fax Number	:	724-770-7930

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	06/18/2025

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