Individual
DR. JASON B WITTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 NW 114TH ST, SUITE 347, DES MOINES, IA 50325-7007
(515) 224-1777
(515) 222-0226
Mailing address
1601 NW 114TH ST, SUITE 347, DES MOINES, IA 50325-7007
(515) 224-1777
(515) 222-0226
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36343
IA
207RP1001X
Pulmonary Disease Physician
Primary
36343
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02019
WELLMARK
IA
05
—
0469304
—
IA
01
—
266915
COVENTRY
IA
01
—
IA0143
UHC OF THE RIVER VALLEY
IA
Enumeration date
12/21/2005
Last updated
07/15/2014
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