IndividualActive
Fredrick Wittleder, PA
NPI 1205195088 · Surgical Physician Assistant · Oak Park Heights, MN
Provider details
- NPI number
- 1205195088
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Surgical Physician Assistant363AS0400X
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone: (651) 439-8807
Fax: (651) 439-0232
Approximate (ZIP-level) locationGet directions
Mailing address
4465 S 900 E
Millcreek, UT 84124-2644
Additional practice locations (1)
- 3000 N Triumph Blvd Ste 110Lehi, UT 84043-7186Phone: (385) 345-3555Fax: (385) 345-3554
Registry dates
- Enumerated
- 2012-05-14
- Last updated
- 2023-10-30
- Certified
- 2023-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.