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NPI Code Detail

MEDICARE: DAVID PITTS MD PA

MEDICARE: DAVID PITTS MD PA
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
1174400000XSpecialist94-120 D.P/94-121 JPNM

Other Identifiers

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

General Provider Information

NPI Number : 1568480440
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID PITTS MD PA
Provider Business Mailing Address
First Line : 1040 SAKELARES BLVD
Second Line :
City : GRANTS
State : NM
Zip : 87020-3819
Country : US
Telephone Number : 505-287-4489
Fax Number : 505-287-8441
Provider Business Practice Location Address
First Line : 1040 SAKELARES BLVD
Second Line :
City : GRANTS
State : NM
Zip : 87020-3819
Country : US
Telephone Number : 505-287-4489
Fax Number : 505-287-8441
Authorized Official
Title or Position : OWNER
Name : DR. DAVID B PITTS
Credential : MD
Telephone Number : 505-287-4489
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/28/2008

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Directions to “DAVID PITTS MD PA ” Practice Location

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