Provider Demographics
NPI:1396947172
Name:RONALD H. WITKIN, MD
Entity type:Organization
Organization Name:RONALD H. WITKIN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-524-9201
Mailing Address - Street 1:85 SPRING ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3113
Mailing Address - Country:US
Mailing Address - Phone:603-524-9201
Mailing Address - Fax:603-524-4338
Practice Address - Street 1:85 SPRING ST
Practice Address - Street 2:SUITE 404
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3113
Practice Address - Country:US
Practice Address - Phone:603-524-9201
Practice Address - Fax:603-524-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30212776Medicaid