Individual
DR. SEAN PITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4101 CAMPUS RIDGE RD, MATTHEWS, NC 28105-5077
(704) 234-1930
(704) 234-1940
Mailing address
4101 CAMPUS RIDGE RD, MATTHEWS, NC 28105-5077
(704) 234-1930
(704) 234-1940
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1529
SC
152W00000X
Optometrist
2166
NC
152W00000X
Optometrist
OEG002130
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0381
MEDICARE GROUP NUMBER FOR EMPLOYEE DR
—
01
—
3063
MEDICARE GROUP NUMBER
SC
05
—
5920824
—
NC
05
—
D15295
—
SC
Enumeration date
09/30/2008
Last updated
07/18/2024
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