Individual
DR. THOMAS C WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 W 16TH ST, SUITE 5100, INDIANAPOLIS, IN 46202-2207
(317) 396-1300
(317) 924-8472
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01044119
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000640512
ANTHEM BLUE CROSS AND BLUE SHIELD
IN
05
—
200060850
—
IN
Enumeration date
05/27/2005
Last updated
11/25/2020
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