Individual
DR. MARY A WITTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157-0001
(336) 716-2255
(336) 716-5438
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6543
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2003-00729
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134YN
BCBS
—
01
—
202780
MEDCOST
—
05
—
3810009143
—
WV
05
—
89134YN
—
NC
05
—
N0072A
—
SC
Enumeration date
07/04/2006
Last updated
09/16/2010
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