Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 20-12651 | SC |
NPI | 1063605905 |
---|---|
Provider Name | Dr. William B. Pittard III |
First Address | Charleston, SC 29425 |
Second Address | Charleston, SC 29425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 23/08/2007 |