Individual
KEITH DANIEL PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8036 PROVIDENCE RD STE 100, CHARLOTTE, NC 28277-0257
(980) 301-8711
(980) 301-8712
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5017255
NC
363L00000X
Nurse Practitioner
PITT-YU2WO
NC
Other
Enumeration date
11/15/2022
Last updated
11/14/2024
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