Individual
BRIAN D WITTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4048 CEDAR BLUFF DR, SUITE 1, PETOSKEY, MI 49770-8895
(231) 347-5155
(231) 347-6128
Mailing address
PO BOX 430, PETOSKEY, MI 49770-0430
(231) 347-5155
(231) 347-6128
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301054711
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307797710
—
MI
Enumeration date
08/07/2006
Last updated
03/02/2020
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