Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | SC001905L | PA |
NPI | 1023071040 |
---|---|
Provider Name | Dr. Jeffrey Michael Witman |
First Address | Lancaster, PA 17601-4372 |
Second Address | Lancaster, PA 17601-4372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 27/04/2011 |