Healthcare Provider Details

I. General information

NPI: 1417579541
Provider Name (Legal Business Name): KELYN N PITTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FEDERAL ST STE 2
PITTSBURGH PA
15212-4769
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7
PITTSBURGH PA
15212-5227
US

V. Phone/Fax

Practice location:
  • Phone: 877-660-6777
  • Fax: 412-359-8055
Mailing address:
  • Phone: 412-330-4461
  • Fax: 412-330-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD489072
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: