Provider Demographics
NPI:1093550394
Name:PITTMAN, JOSHUA (RD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 WINDY MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7050
Mailing Address - Country:US
Mailing Address - Phone:864-320-6544
Mailing Address - Fax:
Practice Address - Street 1:125 HALTON RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3507
Practice Address - Country:US
Practice Address - Phone:864-232-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered