NPI 1114980406 · live from the CMS NPI Registry
Crystal A. De Wit, DO
Anesthesiology, Pain Medicine in Bridgeport, WV. National Provider Identifier 1114980406, active.
NPI record
| NPI | 1114980406 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology, Pain Medicine 207LP2900X |
| Practice location | 527 Medical Park Dr Ste 500, Bridgeport, WV 26330 |
| Practice phone | 681-342-3600 |
| Mailing address | 12 Ashbury Ln, Fairmont, WV 26554 |
| Enumerated | April 9, 2006 |
| Last updated | February 26, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology | 207L00000X | 3780 (WV) |
| Emergency Medicine | 207P00000X | 3780 (WV) |
| Family Medicine | 207Q00000X | 3780 (WV) |
| Anesthesiology, Pain Medicine primary | 207LP2900X | 3780 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.