Individual
DR. MARK ANTHONY PITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8894
(251) 544-2188
Mailing address
251 N BAYOU ST, 7, MOBILE, AL 36603-5827
(251) 690-8894
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
30547
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP NUMBER
AL
01
—
1063439065
SITE NPI GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
04/17/2008
Last updated
12/13/2010
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