Individual
TODD MICHAEL WITZELING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 577-2123
(307) 577-2239
Mailing address
2510 E 15TH ST STE 2, CASPER, WY 82609-4111
(307) 234-9657
(307) 234-0306
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4438A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050010204
RAILROAD MEDICARE
—
01
—
050036353
RAILROAD MEDICARE
—
05
—
103996200
—
WY
05
—
103996201
—
WY
01
—
306554
BLUE SHIELD
—
01
—
307122
BLUE SHIELD
—
Enumeration date
11/02/2006
Last updated
05/07/2012
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