Individual
MARK EVERETT WITTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 N BELAIR RD STE 101, EVANS, GA 30809-6502
(706) 922-3669
Mailing address
104 N BELAIR RD STE 101, EVANS, GA 30809-6502
(706) 922-3669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048862
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00875036B
—
GA
Enumeration date
03/01/2007
Last updated
03/10/2015
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