Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS8978 | FL |
NPI | 1003906355 |
---|---|
Provider Name | Dr. Daniel Phillip Pitstick |
First Address | Gainesville, FL 32610-0371 |
Second Address | Dayton, OH 45409-2722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 24/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
267739300 | (05) | FL |
H82320 | (02) |