Individual
MRS. DEANNA M PITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
O0368
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150852
BLUE SHIELD
ID
05
—
1639169626
—
ID
01
—
75085
BLUE CROSS
ID
05
—
807228800
—
ID
01
—
807228900
HEALTHY CONNECTIONS
ID
Enumeration date
10/21/2005
Last updated
01/25/2024
Update your record
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