Provider Demographics
NPI:1295778652
Name:PITTMAN, PAMELA M (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:M
Last Name:PITTMAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3511 W MARKET ST
Mailing Address - Street 2:STE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-4443
Mailing Address - Country:US
Mailing Address - Phone:336-632-3505
Mailing Address - Fax:336-665-6188
Practice Address - Street 1:522 N ELAM AVE
Practice Address - Street 2:STE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1151
Practice Address - Country:US
Practice Address - Phone:336-632-3505
Practice Address - Fax:336-665-6188
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-02-01
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Provider Licenses
StateLicense IDTaxonomies
NC247982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8967694Medicaid
NC209611DMedicare ID - Type Unspecified
NCE39263Medicare UPIN