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General NPI Number Information
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NPI Number | 1740460351
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Entity Type | Individual
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Provider Name | MICHELLE ANTOINETTE PITTMAN MD
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Gender | Female
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 812 BROADWAY ST
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City | MINDEN
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State | LA
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Zip | 71055-3309
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Country | US
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Telephone | 318-377-4534
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Fax | 318-377-4535
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Provider Business Mailing Address
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Address Line | 346 HOMER RD
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City | MINDEN
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State | LA
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Zip | 71055-2834
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Country | US
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Telephone | 318-377-4625
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Fax | 318-377-8837
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | E-8990
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD.201400
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License Number State | LA
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