Individual
WILLIAM ALLEN WITTCHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4946
(763) 572-5710
(763) 586-5888
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 572-5710
(763) 571-3008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9684
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110259
MEDICA
MN
01
—
1029890
PREFERRED ONE
MN
01
—
104929
UCARE MN
MN
01
—
251J4WI
BCBS OF MN
FM
01
—
25878
AMERICA'S PPO
MN
01
—
6605097
MEDICA URGENT CARE
MN
01
—
HP33986
HEALTHPARTNERS
MN
Enumeration date
09/25/2006
Last updated
07/09/2007
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