MEDICARE: DONNA PITTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053408294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONNA PITTER MD

Provider Business Mailing Address
First Line	:	7 CLYDE RD
Second Line	:
City	:	SOMERSET
State	:	NJ
Zip	:	08873-5049
Country	:	US
Telephone Number	:	866-266-6822
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 W CENTER ST
Second Line	:	#200
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2154
Country	:	US
Telephone Number	:	414-442-7900
Fax Number	:	414-442-8156

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DONNA E PITTER
Credential	:	MD
Telephone Number	:	414-442-7900

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	01/12/2012

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Directions to “DONNA PITTER MD ” Practice Location

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