Individual
DR. TY ROBERT WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19610 N 68TH AVE, GLENDALE, AZ 85308-5515
(623) 215-6532
Mailing address
19610 N 68TH AVE, GLENDALE, AZ 85308-5515
(623) 215-6532
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
30147
AZ
207V00000X
Obstetrics & Gynecology Physician
MD00038457
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020730
—
WA
Enumeration date
08/22/2005
Last updated
06/15/2011
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