Dr. Jeffrey Dean Pittis
Dermatologist
90 Ridgewood Dr
Bangor
, Maine 04401-2652
Dr. Jeffrey Dean Pittis
Dermatologist
90 Ridgewood Dr
Bangor
, Maine 04401-2652
(207) 947-3143
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Jeffrey Dean Pittis
- 90 Ridgewood Dr
- Bangor, ME
- Zip : 04401-2652
- Fax : (207) 947-3143
- Phone : (207) 942-0669
Second Address
- Dr. Jeffrey Dean Pittis
- 90 Ridgewood Dr
- Bangor, ME
- Zip : 04401-2652
- Fax : (207) 947-3143
- Phone : (207) 942-0669
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | ME013153 | ME |
National Provider Identifier
| NPI | 1023006194 |
|---|---|
| Provider Name | Dr. Jeffrey Dean Pittis |
| First Address | Bangor, ME 04401-2652 |
| Second Address | Bangor, ME 04401-2652 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/10/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E98841 | (02) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.