Dewitt, Liza C

Dewitt, Liza C is an individual health care provider with primary practice located at 640 Deerwood Ave , Neenah WI 54956-7110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dewitt, Liza C can be contacted via phone (920) 727-9982.

Contact Information

Primary practice address
640 Deerwood Ave Neenah WI 54956-7110
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 43872-020 Wisconsin

Profile Details

NPI number 1649332297
LBN Legal business name Dewitt, Liza C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Nov 23rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649332297 NPPES
Wisconsin MEDICAID 34325600

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