Look up the most recent NPI and PECOS records

John Frederick Wittenberg

Internal Medicine

Allopathic & Osteopathic Physicians

4001 W 15th St, Suite 245, Plano, TX 75093-5841

PECOS Enrollment

Based on the most recent information from CMS, provider John Frederick Wittenberg does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1063453736
Provider Type
Individual
Full Name
Wittenberg, John Frederick
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/10/2006
Last Updated
6/16/2016

Contact Information

Practice Location

4001 W 15th St, Suite 245, Plano, TX 75093-5841

(972) 596-5222

(972) 596-5291

Mailing Location

4001 W 15th St, Suite 245, Plano, TX 75093-5841

(972) 596-5222

(972) 596-5291

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License F1310 Texas

Provider Identifiers

ID	Description	Issuer
ID 099747002	Description Medicaid	Issuer Unlisted Texas
ID 099747003	Description Other	Issuer MEDICAID OTHER Texas
ID 110129394	Description Other	Issuer RAILROAD MEDICARE Texas

John Frederick Wittenberg

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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