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General NPI Number Information
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NPI Number | 1376560441
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Entity Type | Organization
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Legal Business Name | PITMAN SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 326 MONTICELLO AVE
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2834
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Country | US
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Telephone | 757-229-4958
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Fax | 757-229-3118
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Provider Business Mailing Address
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Address Line | 326 MONTICELLO AVE
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2834
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Country | US
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Telephone | 757-229-4958
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Fax | 757-229-3118
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS LAURA M SMITH
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Credential |
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Telephone | 757-229-4958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101014066
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License Number State | VA
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