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Individual
MR. SHANE MICHAEL PITTMAN
Active
Individual
MR. SHANE MICHAEL PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-M
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
3521-2416-8453
IN
1710I1003X
Independent Duty Medical Technicians
Primary
3251-2416-8453
IN
207P00000X
Emergency Medicine Physician
30018103
IN
Other
Enumeration date
07/14/2025
Last updated
10/28/2025
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