Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01028662A | IN |
N | 111NI0900X | Internist | 01028662A | IN |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 01028662A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 01028662A | IN |
NPI | 1215906490 |
---|---|
Provider Name | Douglas E Pitts |
First Address | Indianapolis, IN 46260-1316 |
Second Address | Indianapolis, IN 46260-1992 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100078120 | (05) | IN |
D95475 | (02) | IN |