Individual
MARCIA L. WITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
209 FOREST ST, MCCALL, ID 83638-5256
(208) 634-1776
(208) 634-3873
Mailing address
1000 STATE ST, MCCALL MEMORIAL HOSPITAL, MCCALL, ID 83638-3704
(208) 634-1776
(208) 634-3873
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8271
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147960
BLUE CROSS OF IDAHO
—
05
—
806952300
—
ID
Enumeration date
01/17/2007
Last updated
08/02/2012
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