Healthcare Provider Details

I. General information

NPI: 1235053422
Provider Name (Legal Business Name): DIANA MARIA PITMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 DAYSTROM DR
GREER SC
29651-1970
US

IV. Provider business mailing address

205 DAYSTROM DR
GREER SC
29651-1970
US

V. Phone/Fax

Practice location:
  • Phone: 864-918-0750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLRD.3311.RD
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: