Organization
JOHN T. WITTE, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T WITTE MD (PROVIDER)
(208) 343-6458
Entity
Organization
Contact information
Practice address
2235 E GALA ST, MERIDIAN, ID 83642-8026
(208) 887-3724
(208) 887-1682
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-1702
(208) 342-7042
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M5529
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002733600
—
ID
Enumeration date
01/13/2010
Last updated
03/20/2018
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