Individual
DR. DIANE MOUNTAIN PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
521 MINNESOTA AVE NW, BEMIDJI, MN 56601-3024
(218) 308-0294
Mailing address
514 BELTRAMI AVE NW, STE 102, BEMIDJI, MN 56601-3010
(218) 308-0294
(888) 375-3627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0296377
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
966553600
—
MN
Enumeration date
08/22/2006
Last updated
12/05/2016
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