Robert Wittchow, D.O.
Individual provider Active NPI Diagnostic Radiology Physician · Bayside, WI
NPI 1508849779 · NPPES record last updated May 29, 2014
Key facts
- NPI
- 1508849779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 26900 (WI)
- Practice address
- 500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618 - Phone
- (414) 434-0461
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Medical Group, LLC | Diagnostic Radiology | Past | Accepting new patients |
| Ascension Medical Group-Southeast Wisconsin Inc | Diagnostic Radiology | Past | Accepting new patients |
| Aurora Advanced Healthcare Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 26900 | WI | Yes |
Addresses
Primary practice location
500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618
Mailing address
500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618
Other providers in Bayside, WI
All providers in Bayside, WI · Diagnostic Radiology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.