Individual
KENNETH J PITUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 12TH FLOOR CS MOTT CHILDRENS HOSPITAL ROOM 525, ANN ARBOR, MI 48109-4280
(734) 763-5302
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301044959
MI
208M00000X
Hospitalist Physician
4301044959
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3150450
—
MI
Enumeration date
07/27/2006
Last updated
04/29/2013
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