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Individual
PHILIP C. DITTMAR
Active
Individual
PHILIP C. DITTMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
D67503
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417536100
—
MD
01
—
936251-02 & -03
BLUE CROSS BLUE SHIELD
MD
01
—
S062-0350
BC/BS REGIONAL
MD
Enumeration date
02/18/2007
Last updated
02/01/2013
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