Provider Demographics
NPI:1649289810
Name:WITKIN, DAVID BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:WITKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1755 COBURG RD
Mailing Address - Street 2:BUILDING 1, SUITE 4
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4982
Mailing Address - Country:US
Mailing Address - Phone:541-683-2888
Mailing Address - Fax:541-683-3289
Practice Address - Street 1:1755 COBURG RD
Practice Address - Street 2:BUILDING 1, SUITE 4
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4982
Practice Address - Country:US
Practice Address - Phone:541-683-2888
Practice Address - Fax:541-683-3289
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD 13391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine