Individual
GEORGE TITTMANN RECORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
341 SPRUCE ST, MILAN PUSKAR HEALTH RIGHT, MORGANTOWN, WV 26505-5504
(304) 292-8234
(304) 284-0133
Mailing address
206 JENNY LYNN EST, MORGANTOWN, WV 26508-4821
(860) 601-8420
(304) 291-0901
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
28630
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001286302
—
CT
01
—
001286302-02
BLUECARE FAMILY PLAN (MCD
CT
01
—
010018270CT04
ANTHEM BC/BS
CT
01
—
028630
CONNECTICARE
—
01
—
1710966098
MT ST BCBS #
WV
01
—
2V4659
HEALTHNET
—
01
—
3487054
AETNA
—
05
—
3810016952
—
WV
Enumeration date
01/13/2006
Last updated
05/23/2014
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