Individual
DR. ALBERT A WITTE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 887-3643
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A-853-87
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000R9166
—
NM
Enumeration date
05/05/2006
Last updated
04/29/2019
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