Wittberg, Kathleen R

Wittberg, Kathleen R is an individual health care provider with primary practice located at 9000 North Main St Main Street Family Practice Inc Suite 403, Dayton OH 45415-1180. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wittberg, Kathleen R can be contacted via phone (937) 836-5171.

Contact Information

Primary practice address
9000 North Main St Main Street Family Practice Inc Suite 403 Dayton OH 45415-1180
Phone: (937) 836-5171
Fax: (937) 832-0728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35048051 Ohio

Profile Details

NPI number 1144220641
LBN Legal business name Wittberg, Kathleen R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Mar 24th, 2008 - about 17 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 1144220641 NPPES
Ohio Other 1139935 CIGNA
Ohio Other 000000013668 CIGNA
Ohio Other 4328348 CIGNA
Ohio MEDICAID 0534265 CIGNA
Ohio Other 0122424 CIGNA

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