Individual
FREDRICK C WITTLEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232
Mailing address
4465 S 900 E, STE 275, MILLCREEK, UT 84124-2644
(651) 439-8807
(651) 439-0232
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
10749979-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
—
MN
363AS0400X
Surgical Physician Assistant
—
WI
Other
Enumeration date
05/14/2012
Last updated
10/30/2023
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