Provider Demographics
NPI:1700862927
Name:WITT, WARREN HARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:HARRY
Last Name:WITT
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 1:95-270 WAIKALANI DR
Mailing Address - Street 2:J-303
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3527
Mailing Address - Country:US
Mailing Address - Phone:808-623-2979
Mailing Address - Fax:
Practice Address - Street 1:MAKALAPA MEDICAL CLINIC
Practice Address - Street 2:480 CENTRAL AVE
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-4908
Practice Address - Country:US
Practice Address - Phone:808-473-1880
Practice Address - Fax:808-473-4411
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-4672208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice