Provider Demographics
NPI:1003919804
Name:PITTMAN, WILLIAM B (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7867
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0867
Mailing Address - Country:US
Mailing Address - Phone:252-451-2700
Mailing Address - Fax:252-451-2703
Practice Address - Street 1:155 NASHVILLE COMMONS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1823
Practice Address - Country:US
Practice Address - Phone:252-459-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20679207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5600998OtherCIGNA HEALTHCARE
NC29355OtherMEDCOST
NC8968053Medicaid
NC68053OtherBCBSNC
NC110095572OtherRAILROAD MEDICARE
NC68053OtherBCBSNC
NCC86005Medicare UPIN