Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME149599 | FL |
N | 208200000X | Surgeon | MT211782 | PA |
N | 208600000X | Surgeon | MT211782 | PA |
NPI | 1043660798 |
---|---|
Provider Name | Dr. Matthew Hunter Witt |
First Address | Tampa, FL 33601-1289 |
Second Address | Tampa, FL 33606-3571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 14/01/2022 |