Provider Demographics
NPI:1982633418
Name:HITTER, SCOTT ROBERT (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ROBERT
Last Name:HITTER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 OLDE WATERFORD WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4125
Mailing Address - Country:US
Mailing Address - Phone:910-383-2182
Mailing Address - Fax:
Practice Address - Street 1:509 OLDE WATERFORD WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4125
Practice Address - Country:US
Practice Address - Phone:910-383-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104015363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical