Basic Information
| Provider Information | |||||||||
| NPI: | 1760725485 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WITTE | ||||||||
| FirstName: | DEIRDRE | ||||||||
| MiddleName: | HARMONY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3525 SOUTHERN BLVD | ||||||||
| Address2: | |||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454291221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373958839 | ||||||||
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| Practice Location | |||||||||
| Address1: | SALEM EMERGENCY PHYSICIANS, C/O SALEM HOSPITAL ED | ||||||||
| Address2: | 890 OAK ST, SE, BUILDING A | ||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038141279 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2013 | ||||||||
| LastUpdateDate: | 02/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD183160 | OR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.