Provider Demographics
NPI:1437266277
Name:PITTAWAY, DONALD EDWARD SR (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:EDWARD
Last Name:PITTAWAY
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 BROOKVIEW HILLS BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5661
Mailing Address - Country:US
Mailing Address - Phone:336-765-1464
Mailing Address - Fax:336-765-2492
Practice Address - Street 1:3333 BROOKVIEW HILLS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5661
Practice Address - Country:US
Practice Address - Phone:336-765-1464
Practice Address - Fax:336-765-2492
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC26858207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9690706OtherCIGNA
74-07470OtherUNITED HEALTHCARE
81281OtherMEDCOST
458OtherPARTNERS
NC8967838Medicaid
NC67838OtherBLUE CROSS/BLUE SHIELD
458OtherPARTNERS
NCC86002Medicare UPIN