Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4018 | OK |
NPI | 1033221403 |
---|---|
Provider Name | Gabriel M Pitman |
First Address | Oklahoma City, OK 73139 |
Second Address | Oklahoma City, OK 73139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 20/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200011220A | (05) | OK |
200011220B | (05) | OK |
P00066226 | RAILROAD MEDICARE (01) | OK |
P00722130 | RAILROAD MCARE THRU NSO (01) | OK |