Individual
DR. GAVIN T PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 JACKSON ST - MC 11503L, HEALTHPARTNERS REGIONSL SPECIALTY CLINICS, ST. PAUL, MN 55101-2502
(651) 254-2005
(651) 254-1519
Mailing address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 883-5375
(651) 254-1519
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
47753
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135135E949
UCARE
—
01
—
332G2PI
BLUECROSSBLUESHIELD
—
05
—
660273800
—
MN
01
—
901999
MEDICA
—
01
—
969991044105
PREFERREDONE
—
01
—
HP52033
HEALTHPARTNERS
—
Enumeration date
07/18/2006
Last updated
10/25/2018
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