Provider Demographics
NPI:1518085562
Name:WITTE, BRIAN FREDERICK (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:FREDERICK
Last Name:WITTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 OLIVER WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8486
Mailing Address - Country:US
Mailing Address - Phone:614-560-7317
Mailing Address - Fax:
Practice Address - Street 1:7248 OLIVER WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8486
Practice Address - Country:US
Practice Address - Phone:614-560-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.008393207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology