Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | OT015103 | PA |
NPI | 1033552575 |
---|---|
Provider Name | Aaron David Dewitt |
First Address | Wilmington, OH 45177-2121 |
Second Address | Erie, PA 16509-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2013 |
Last Update Date | 30/08/2017 |