Individual
BRUCE EVAN WITMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6255 SHARLANDS AVE, RENO, NV 89523-2882
(775) 248-1267
(775) 305-1267
Mailing address
6255 SHARLANDS AVE, RENO, NV 89523-2882
(775) 248-1267
(775) 305-1267
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
8283
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11191170
CAQH
—
05
—
20-16215
—
NV
01
—
XPY194499
MEDI-CAL PIN
CA
Enumeration date
11/11/2005
Last updated
07/16/2021
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