Organization Name: | BRIAN D WITTENBERG MD PC |
NPI Number: | 1952694010 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN D WITTENBERG (PRESIDENT) |
Mailing Address: | 14715 W Upright St Charlevoix |
State: | MI US |
Postal Code: | 497201949 |
Phone Number: | 2313475155 |
Fax Number: | 2313476128 |
NPI Enumeration Date: | 05/24/2011 |
NPI Last Update Date: | 05/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 4301054711 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |