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Individual

JOHN WILLIAM WITTENBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
127 WAMSUTTA MILL RD STE D, MORGANTON, NC 28655-5523
(828) 430-3511
(828) 368-4303
Mailing address
PO BOX 120590, NEWPORT NEWS, VA 23612-0590
(757) 867-6102
(757) 867-6588

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
200000669
NC
2085R0202X
Diagnostic Radiology Physician
Primary
200000669
NC
2085R0202X
Diagnostic Radiology Physician
TM203
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1345J
BCBS
NC
05
835680
SC
05
891345J
NC
01
P00060418
RR MEDICARE
NC
01
SCH506E474
MEDICARE OF SOUTH CAROLINA
SC
Enumeration date
09/07/2006
Last updated
09/02/2025
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