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General NPI Number Information
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NPI Number | 1083614259
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Entity Type | Individual
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Provider Name | SHOLAH P PITTMAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2400 MOUNT ZION PKWY KAISER PERMANENTE SOUTHWOOD COMPREHENSIVE MEDICAL CENTE
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City | JONESBORO
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State | GA
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Zip | 30236-2500
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Country | US
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Telephone | 770-603-3649
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C4387
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13211
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 053315
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 04-51275
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME168489
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License Number State | FL
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