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Contact Information

GARY WITUCKI, DO
1234 NAPIER AVE
SAINT JOSEPH, MI49085-2112
 Phone: 269-983-8601
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GARY WITUCKI · (Male)

NPI # 1184699472
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/21/2006
Last updated 10/30/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • KY License # 03087
  • MI License # 5101011763
  • WI License # 57339
  • KY Medicaid 7100075950
  • TN Medicaid 3300156
  • KY Other 000000601505 ANTHEM
Hospital affiliation(s)
  • LAKELAND HOSPITAL ST JOSEPH - (Acute Care)
    1234 NAPIER AVENUE
    ST JOSEPH, MI 49085
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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