Provider Demographics
NPI:1740217801
Name:PITTS, VENUS IDETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:VENUS
Middle Name:IDETTE
Last Name:PITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 N DUKE ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-3048
Mailing Address - Country:US
Mailing Address - Phone:919-416-4700
Mailing Address - Fax:919-416-0821
Practice Address - Street 1:2609 N DUKE ST
Practice Address - Street 2:SUITE 403
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3048
Practice Address - Country:US
Practice Address - Phone:919-416-4700
Practice Address - Fax:919-416-0821
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900644207R00000X, 208000000X, 207RB0002X, 207RA0401X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2026035AOtherMEDICARE ID
NC89136E4Medicaid
NC89136E4NCMedicaid
NC2026035AOtherMEDICARE ID
NC89136E4Medicaid