Individual
DR. CORY J PITRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 SENATE BLVD, EMERGENCY DEPT, INDIANAPOLIS, IN 46202-1239
(317) 962-8880
(317) 962-7086
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01057801
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511820
—
IN
01
—
P00924305
RAILROAD MEDICARE PTAN
IN
Enumeration date
12/28/2006
Last updated
02/02/2021
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