Organization
BRIAN D WITTENBERG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT HAUGER (BILLING MANAGER)
(231) 439-8017
Entity
Organization
Contact information
Practice address
4048 CEDAR BLUFF DR, STE 1, PETOSKEY, MI 49770-8895
(231) 439-8017
(231) 347-6128
Mailing address
4048 CEDAR BLUFF DR, STE1 PO BOX 430, PETOSKEY, MI 49770-8895
(231) 439-8017
(231) 347-6128
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301054711
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307797710
—
MI
Enumeration date
12/14/2009
Last updated
12/14/2009
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