Sholah P Pittman, MD | |
2400 Mount Zion Pkwy, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236-2500 | |
(770) 603-3649 | |
Not Available |
Full Name | Sholah P Pittman |
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Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 2400 Mount Zion Pkwy, Jonesboro, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083614259 | NPI | - | NPPES |
58-1397572 | Other | TAX ID | |
541411884 | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | ME168489 (Florida) | Secondary |
207V00000X | Obstetrics & Gynecology | 053315 (Georgia) | Primary |
Entity Name | The Southeast Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
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Sholah P Pittman, MD 3495 Piedmont Rd Ne, Nine Piedmont Center, Atlanta, GA 30305-1717 Ph: (404) 504-5678 | Sholah P Pittman, MD 2400 Mount Zion Pkwy, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236-2500 Ph: (770) 603-3649 |
Linda R Myrick, CNP Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 2400 Mount Zion Parkway, Department Of Obstetrics And Gynecology, Jonesboro, GA 30236 Phone: 404-364-7000 | |
Karanvir S Virk, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2400 Mt Zion Parkway, Jonesboro, GA 30236 Phone: 770-603-4217 Fax: 770-603-4218 | |
Ms. Docile Donna Aguirre Saguan, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 Phone: 770-603-3668 | |
Dr. Jonathan Fitzgerald Hill Jr., M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2400 Mount Zion Pkwy Dept Of, Jonesboro, GA 30236 Phone: 800-611-1811 | |
Sandra Dee Smith, CNM Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 2400 Mount Zion Parkway, Department Of Obstetrics & Gynecology, Jonesboro, GA 30236 Phone: 404-364-7000 | |
Ms. Ericka Camille Gibson, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 2400 Mount Zion Pkwy, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 Phone: 770-603-3649 Fax: 202-448-1620 |