Provider Demographics
NPI:1386276558
Name:WITTWER, ROBERT (CRNA)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WITTWER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 3 BOX 6731
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96266-0068
Mailing Address - Country:US
Mailing Address - Phone:010-396-7843
Mailing Address - Fax:
Practice Address - Street 1:51MDG/HCOS
Practice Address - Street 2:BLDG 777
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:96266
Practice Address - Country:US
Practice Address - Phone:315-784-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002804367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered