MEDICARE: SCOTT ROBERT HITTER 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
1	363AM0700X	Medical Physician Assistant	104015	NC

General Provider Information

NPI Number	:	1982633418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ROBERT HITTER PA

Provider Business Mailing Address
First Line	:	509 OLDE WATERFORD WAY
Second Line	:	SUITE 101
City	:	LELAND
State	:	NC
Zip	:	28451-4125
Country	:	US
Telephone Number	:	910-383-2182
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 OLDE WATERFORD WAY
Second Line	:	SUITE 101
City	:	LELAND
State	:	NC
Zip	:	28451-4125
Country	:	US
Telephone Number	:	910-383-2182
Fax Number	:

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/08/2007

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Directions to “ SCOTT ROBERT HITTER PA” Practice Location

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