Doctor Name: | MICHAEL WITTEK |
NPI Number: | 1043301161 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RPA |
License Number: | 006198 |
Business Practice Address: | 6254 Lawville Rd Wolcott, NY - 145909792 |
Business Phone Number: | 3155949444 |
Business Fax Number: | |
Mailing Address: | 326 N Main St, CANANDAIGUA |
State: | NY |
Postal Code: | 144241222 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 12/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 006198 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |