Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | OS017021 | PA |
NPI | 1063672194 |
---|---|
Provider Name | Michael F Ditillo |
First Address | Pittsburgh, PA 15212-4756 |
Second Address | Pittsburgh, PA 15212-4756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 01/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102911435 | (05) | PA |