Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 9900644 | NC |
Y | 111NI0900X | Internist | 9900644 | NC |
N | 207RA0401X | Internist - Addiction Medicine | 9900644 | NC |
N | 208000000X | Pediatrician | 9900644 | NC |
NPI | 1740217801 |
---|---|
Provider Name | Dr. Venus Idette Pitts |
First Address | Durham, NC 27704-3048 |
Second Address | Durham, NC 27704-3048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 06/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2026035A | MEDICARE ID (01) | NC |
89136E4 | (05) | NC |
89136E4NC | (05) | NC |
I08128 | (02) | NC |
I0818 | (02) |