Provider Demographics
NPI:1639137706
Name:WITTE, ANTHONY J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:WITTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10869 RTE 36 SOUTH
Mailing Address - Street 2:PO BOX 601
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-0601
Mailing Address - Country:US
Mailing Address - Phone:585-335-3416
Mailing Address - Fax:585-335-8695
Practice Address - Street 1:157 TOWNE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-9425
Practice Address - Country:US
Practice Address - Phone:802-454-8336
Practice Address - Fax:802-454-8339
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY169902207Q00000X, 207QH0002X
VT042.0016083207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01282291Medicaid
NY080148592Medicare PIN
NY10651EMedicare PIN
NYB81124Medicare UPIN