Healthcare Provider Details
I. General information
NPI: 1790777415
Provider Name (Legal Business Name): HOWARD PITTLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 08/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5247 BROWNSVILLE RD
PITTSBURGH PA
15236-2756
US
IV. Provider business mailing address
506 ATHENA DR
DELMONT PA
15626-1005
US
V. Phone/Fax
- Phone: 412-943-1300
- Fax: 412-943-1311
- Phone: 724-468-6869
- Fax: 724-468-6207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD050756L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: