Provider Demographics
NPI:1841558772
Name:WIITA, PATRICK GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:GEORGE
Last Name:WIITA
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 1:33 OFFICE PARK RD STE A-166
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4612
Mailing Address - Country:US
Mailing Address - Phone:843-802-9030
Mailing Address - Fax:
Practice Address - Street 1:33 OFFICE PARK RD STE A-166
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4612
Practice Address - Country:US
Practice Address - Phone:843-802-9030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC821432084P0800X
CAA1249382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry