Provider Demographics
NPI:1598269235
Name:PITTMAN, ELLEN JUDITH (MD)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:JUDITH
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:UNIVERSITY OF MICHIGAN CONGENITAL HEART CENTER
Mailing Address - Street 2:1540 E HOSPITAL DR
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109
Mailing Address - Country:US
Mailing Address - Phone:734-936-4038
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MICHIGAN CONGENITAL HEART CENTER
Practice Address - Street 2:1540 E HOSPITAL DR
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109
Practice Address - Country:US
Practice Address - Phone:734-936-4038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2024-07-12
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43015119222080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology