Blake Wittenberg, is a
Student In An Organized Health Care Education/training Program physician based in Aurora, Colorado. Blake Wittenberg is licensed to practice in Colorado (license number TL.0007205) and his current practice location is 12631 E 17th Ave Ste C307, Aurora, Colorado. He can be reached at his office (for appointments etc.) via phone at
(230) 530-3724.
NPI number for Blake Wittenberg is 1982191003 and his current mailing address is 12631 E 17th Ave Ste C307, Aurora, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1982191003.
Physician's Profile
| Full Name | Blake Wittenberg |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 12631 E 17th Ave Ste C307, Aurora, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1982191003
- Provider Enumeration Date: 04/14/2018
- Last Update Date: 05/22/2018
Medical Identifiers
Medical identifiers for Blake Wittenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982191003 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207T00000X | Neurological Surgery | TL.0007205 (Colorado) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | TL.0007205 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Wittenberg is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Blake Wittenberg,
12631 E 17th Ave Ste C307,
Aurora, CO 80045-2527
Ph: () - | Blake Wittenberg,
12631 E 17th Ave Ste C307,
Aurora, CO 80045
Ph: (230) 530-3724 |
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