Bruce R Witten, M.D.
Otolaryngology in St Augustine, FL. Individual provider (NPI-1).
NPI number1962425207
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1962425207
- Entity type
- Individual (NPI-1)
- Name
- Bruce R Witten
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 26, 2006
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | ME0013869 | FL | Yes |
Practice location
301 Health Park BlvdSuite 323
St Augustine, FL 32086-5793
Phone 904-829-6441 · Fax 904-829-2452
Mailing address
301 Health Park BlvdSuite 323
St Augustine, FL 32086-5793
Phone 904-829-6441 · Fax 904-829-2452
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