Provider Demographics
NPI:1497743017
Name:PITTERMAN, ARTHUR BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:BENJAMIN
Last Name:PITTERMAN
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 1:1706 BEARDEN DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106
Mailing Address - Country:US
Mailing Address - Phone:702-366-1250
Mailing Address - Fax:702-366-7068
Practice Address - Street 1:1706 BEARDEN DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106
Practice Address - Country:US
Practice Address - Phone:702-366-1250
Practice Address - Fax:702-366-7068
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2021-08-20
Deactivation Date:2019-08-08
Deactivation Code:
Reactivation Date:2021-08-20
Provider Licenses
StateLicense IDTaxonomies
NV4846207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV110006344OtherRAILROAD MEDICARE
25920OtherBLUE CROSS BLUE SHIELD
NV002002664Medicaid
NVC96443Medicare UPIN
25920OtherBLUE CROSS BLUE SHIELD