Provider Demographics
NPI:1871620757
Name:WITTES, ROBERT C (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:WITTES
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 1:192 THORNWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:THORNHILL
Mailing Address - State:ON
Mailing Address - Zip Code:L4J7Z2
Mailing Address - Country:CA
Mailing Address - Phone:905-771-7505
Mailing Address - Fax:
Practice Address - Street 1:WITS-END MED CLINIC, NORTH BUILDING
Practice Address - Street 2:7131 BATHURST STREET, SUITE 301
Practice Address - City:THORNHILL
Practice Address - State:ON
Practice Address - Zip Code:L4J7Z1
Practice Address - Country:CA
Practice Address - Phone:905-771-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48977207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine