Individual
LAWRENCE W WITZBERGER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10 MEDICAL PARK, SUITE 206, WHEELING, WV 26003-6379
(304) 243-6534
(304) 243-8575
Mailing address
10 MEDICAL PARK, SUITE 206, WHEELING, WV 26003-6379
(304) 243-6534
(304) 243-8575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1636
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0350220
—
OH
Enumeration date
06/13/2012
Last updated
06/03/2020
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