Active NPI
Peter H Wittenberg, MD
- Anatomic Pathology & Clinical Pathology Physician
- Gastonia, NC
National Provider Identifier
1194726612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 22866
- Practice address
- 2525 Court Dr
Gastonia, NC 28054-2140 - Phone
- (704) 834-2851
- Fax
- (704) 834-2815
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 22866 | NC | Primary |
Addresses
Primary practice location
2525 Court Dr
Gastonia, NC 28054-2140
Mailing address
1760 Country Club Dr
Gastonia, NC 28054-0220
Phone (704) 834-2851
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22866 | NC | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194726612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 COUNTRY CLUB DR",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280540220",
"telephone_number": "704-834-2851",
"fax_number": "704-834-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 COURT DR",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542140",
"telephone_number": "704-834-2851",
"fax_number": "704-834-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTENBERG",
"first_name": "PETER",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NC",
"license": "22866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.