Individual
MRS. ELIZABETH RENEE WITTENMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5330 E STOP 11 RD, INDIANAPOLIS, IN 46237-6345
(317) 893-1900
(317) 893-1901
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10000617
IN
363A00000X
Physician Assistant
Primary
10000617A
IN
363A00000X
Physician Assistant
PA200258
LA
Other
Enumeration date
10/17/2006
Last updated
10/02/2023
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