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Individual

DR. KATHLEEN R WITTBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9000 NORTH MAIN ST, MAIN STREET FAMILY PRACTICE INC SUITE 403, DAYTON, OH 45415-1180
(937) 836-5171
(937) 832-0728
Mailing address
9000 NORTH MAIN ST, SUITE 403 MAIN STREET FAMILY PRACTICE INC, DAYTON, OH 45415-1180
(937) 836-1572
(937) 832-0728

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35048051
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000013668
ANTHEM DR WITTBERG
OH
01
0122424
UHC DR WITTBERG
OH
05
0534265
OH
01
1139935
CIGNA
OH
01
4328348
AETNA DR WITTBERG
OH
Enumeration date
07/26/2005
Last updated
03/24/2008
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