MEDICARE: DR. SUSAN SAJESKI PITTS M.D.

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	28556	NC

General Provider Information

NPI Number	:	1194814079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN SAJESKI PITTS M.D.

Provider Business Mailing Address
First Line	:	7228 PITTSBORO - MONCURE RD.
Second Line	:
City	:	MONCURE
State	:	NC
Zip	:	27559
Country	:	US
Telephone Number	:	919-542-4991
Fax Number	:	919-542-3726

Provider Business Practice Location Address
First Line	:	7228 PITTSBORO - MONCURE RD.
Second Line	:
City	:	MONCURE
State	:	NC
Zip	:	27559
Country	:	US
Telephone Number	:	919-542-4991
Fax Number	:	919-542-3726

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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