Individual
GARY M PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY STE 502, DAYTONA BEACH, FL 32117-5169
(386) 231-3570
(386) 231-3571
Mailing address
305 MEMORIAL MEDICAL PKWY STE 502, DAYTONA BEACH, FL 32117-5169
(386) 231-3570
(386) 231-3571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01043021
IN
207Q00000X
Family Medicine Physician
Primary
ME148019
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000767103
ANTHEM
IN
05
—
100376300A
—
IN
01
—
PO1114038
RR MEDICARE
IN
Enumeration date
02/28/2006
Last updated
04/30/2021
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