Healthcare Provider Details

I. General information

NPI: 1588034144
Provider Name (Legal Business Name): DIMITRI ZIVKO PITOVSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 MEDICAL CENTER DR UNIT 100B
WILMINGTON NC
28401
US

IV. Provider business mailing address

1098 MEDICAL CENTER DR STE A
WILMINGTON NC
28401-7365
US

V. Phone/Fax

Practice location:
  • Phone: 910-399-2882
  • Fax: 866-336-5949
Mailing address:
  • Phone: 910-399-2882
  • Fax: 866-336-5949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number2007-01377
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number2007-01377
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2007-01377
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number2007-01377
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: