Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD039663L | PA |
NPI | 1154314888 |
---|---|
Provider Name | Dr. Paul J Witt |
First Address | Plains, PA 18705-2007 |
Second Address | Plains, PA 18705-2007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 30/06/2010 |