Provider Demographics
NPI:1851680284
Name:WITTHOFF, E. MILTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:E.
Middle Name:MILTON
Last Name:WITTHOFF
Suffix:JR
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 1:1563 TORBERT LN
Mailing Address - Street 2:
Mailing Address - City:JERSEY SHORE
Mailing Address - State:PA
Mailing Address - Zip Code:17740
Mailing Address - Country:US
Mailing Address - Phone:570-753-5964
Mailing Address - Fax:
Practice Address - Street 1:1563 TORBERT LN
Practice Address - Street 2:
Practice Address - City:JERSEY SHORE
Practice Address - State:PA
Practice Address - Zip Code:17740
Practice Address - Country:US
Practice Address - Phone:570-753-5964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006295E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice