Individual
EDWARD G. WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11220 MEMORIAL PKWY SW, SUITE AB, HUNTSVILLE, AL 35803-4415
(256) 880-5818
(256) 883-5346
Mailing address
11220 S MEMORIAL PKWY, SUITE A,B, HUNTSVILLE, AL 35803-4415
(256) 880-5818
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1742
TN
207Q00000X
Family Medicine Physician
Primary
DO-556
AL
207QA0401X
Addiction Medicine (Family Medicine) Physician
DO-556
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4120997
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/06/2006
Last updated
11/26/2012
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