Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | D 55469 | MD |
NPI | 1225123680 |
---|---|
Provider Name | Dr. Rachel Witten |
First Address | Rockville, MD 20850 |
Second Address | Gaithersburg, MD 20877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |