Individual
DR. JESSE CALVIN PITTARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 CANTERBURY RD, SMITHFIELD, NC 27577-4861
(919) 934-5149
(919) 934-5632
Mailing address
410 CANTERBURY RD, SMITHFIELD, NC 27577-4861
(919) 934-5149
(919) 934-5632
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21845
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080063191
RAILROAD MEDICARE
NC
05
—
8967836
—
NC
Enumeration date
09/01/2006
Last updated
08/13/2008
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