Individual
MARK ALAN PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD, DEPARTMENT OF EMERGENCY MEDICINE, GREENVILLE, SC 29605-4210
(864) 455-7899
(864) 455-5474
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
39162
SC
207P00000X
Emergency Medicine Physician
D77146
MD
207P00000X
Emergency Medicine Physician
MD043132
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391622
—
SC
01
—
SC8302
MEDICARE PTAN
SC
Enumeration date
04/28/2011
Last updated
06/10/2021
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