Provider Demographics
NPI:1609975150
Name:WITTCOFF, HAROLD P (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:P
Last Name:WITTCOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1736
Mailing Address - Country:US
Mailing Address - Phone:404-364-7165
Mailing Address - Fax:
Practice Address - Street 1:3495 PIEDMONT RD NE
Practice Address - Street 2:NINE PIEDMONT CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1773
Practice Address - Country:US
Practice Address - Phone:404-364-7165
Practice Address - Fax:404-364-7376
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050082207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
16BBBNSMedicare ID - Type Unspecified
D53250Medicare UPIN