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Individual

DR. JAMES F WITKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, FCCP

Contact information

Practice address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
(434) 575-8929
Mailing address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
(434) 575-8929

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0101042054
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006013899
VA
01
032654
ANTHEM BC PROVIDER #
VA
01
2317122
MEDICARE GROUP #
NC
01
88661
BC/BS OF NC PROVIDER #
NC
05
890556G
NC
Enumeration date
03/28/2006
Last updated
01/04/2008
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