Individual
DR. ANDRE J WITKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WASHINGTON ST, BOX 450, BOSTON, MA 02111-1552
(917) 647-3829
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
250825
MA
207W00000X
Ophthalmology Physician
MD439612
PA
207WX0107X
Retina Specialist (Ophthalmology) Physician
15686
NH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
250825
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110093174A
—
MA
05
—
3081668
—
NH
Enumeration date
01/22/2008
Last updated
05/11/2020
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