Individual
KATHLEEN SUE WITTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4189 WESTLAWN S, IOWA CITY, IA 52242-1100
(319) 335-8392
(319) 335-7247
Mailing address
4189 WESTLAWN S, IOWA CITY, IA 52242-1100
(319) 335-8392
(319) 335-7247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-098826
IL
207Q00000X
Family Medicine Physician
Primary
31914
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23364
WELLMARK BCBS
IA
05
—
4141325
—
IA
Enumeration date
06/09/2006
Last updated
03/10/2014
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