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General NPI Number Information
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NPI Number | 1639263098
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Entity Type | Individual
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Provider Name | WILLIAM JOHN PITTAS D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 2578 MCLEOD DR N
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City | SAGINAW
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State | MI
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Zip | 48604-2859
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Country | US
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Telephone | 989-497-3157
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Fax | 989-497-3158
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Provider Business Mailing Address
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Address Line | 2578 MCLEOD DR N
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City | SAGINAW
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State | MI
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Zip | 48604-2859
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Country | US
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Telephone | 989-497-3157
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Fax | 989-497-3158
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 5101015176
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 5101015176
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 5101015176
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License Number State | MI
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