Healthcare Provider Details

I. General information

NPI: 1962465856
Provider Name (Legal Business Name): DITTE K KARLOVITS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DITTE HJARNO KNUDSEN

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EAGLEVIEW CT
GIBSONIA PA
15044-8077
US

IV. Provider business mailing address

810 CLAIRTON BLVD
PITTSBURGH PA
15236-4567
US

V. Phone/Fax

Practice location:
  • Phone: 724-831-9750
  • Fax:
Mailing address:
  • Phone: 412-466-5004
  • Fax: 412-466-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS013666
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1016072350001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: