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Individual

DR. MICHAEL B PITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2450 RIVERSIDE AVE, M653 EAST BUILDING, MINNEAPOLIS, MN 55454-1450
(612) 624-9668
Mailing address
2450 RIVERSIDE AVE, M653 EAST BUILDING, MINNEAPOLIS, MN 55454-1450
(612) 624-9668

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125-052976
IL
208000000X
Pediatrics Physician
Primary
56404
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125-052976
ILLINOIS LICENSE NUMBER
IL
01
56404
MINNESOTA LICENSE NUMBER
MN
Enumeration date
08/11/2008
Last updated
06/04/2013
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