Provider Demographics
NPI:1043680515
Name:HPW CENTER FOR DIABETES, LLC
Entity Type:Organization
Organization Name:HPW CENTER FOR DIABETES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:812-235-8496
Mailing Address - Street 1:3560 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-5540
Mailing Address - Country:US
Mailing Address - Phone:812-235-8496
Mailing Address - Fax:812-478-1540
Practice Address - Street 1:3560 S 4TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5540
Practice Address - Country:US
Practice Address - Phone:812-235-8496
Practice Address - Fax:812-478-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058414207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty