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Individual

DR. SHANNON LAWRENCE PITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 RIVERSTONE VIS, STE 211, BLUE RIDGE, GA 30513-6648
(706) 632-3670
(706) 632-5928
Mailing address
101 RIVERSTONE VIS, STE 211, BLUE RIDGE, GA 30513-6648
(706) 632-3670
(706) 632-5928

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
060550
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
705001609B
GA
05
705001609D
GA
Enumeration date
11/07/2006
Last updated
02/20/2017
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