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Organization
NORTHWEST SURGICAL SPECIALISTS INC.
Active
Organization
NORTHWEST SURGICAL SPECIALISTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE ANTOINETTE PITTMAN MD (OWNER)
(318) 675-1322
Entity
Organization
Contact information
Practice address
1801 FAIRFIELD AVE, SUITE 408, SHREVEPORT, LA 71101-4468
(318) 675-1322
(318) 675-1332
Mailing address
1801 FAIRFIELD AVE, SUITE 408, SHREVEPORT, LA 71101-4468
(318) 675-1322
(318) 675-1332
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
201400
LA
Other
Enumeration date
11/12/2007
Last updated
01/09/2012
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