1922282235 NPI number — STEPHEN R. PITTMAN, DPM PA

Table of content: (NPI 1922282235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922282235 NPI number — STEPHEN R. PITTMAN, DPM PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN R. PITTMAN, DPM PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922282235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
410 CHRISTIANA MEDICAL CTR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19702-1654
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-368-5000
Provider Business Mailing Address Fax Number:
302-368-9026

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 CHRISTIANA MEDICAL CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19702-1654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-368-5000
Provider Business Practice Location Address Fax Number:
302-368-9026
Provider Enumeration Date:
12/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PITTMAN, DPM PA
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
302-368-5000

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E1-0000070 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 177118 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 35024901 . This is a "BS MARYLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4368618 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000148350 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 512066757 . This is a "BS DELAWARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 210674 . This is a "ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1466337 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 210674 . This is a "OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".




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