Basic Information
Provider Information
NPI: 1003293291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUILDING PITA
FirstName: MICHAEL
MiddleName: CHRISTOPHER
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 15 S MAIN STREET
Address2: SUITE 300
City: JAMESTOWN
State: NY
PostalCode: 14701
CountryCode: US
TelephoneNumber: 7163669008
FaxNumber: 7163663158
Practice Location
Address1: CHAUTAUQUA MEDICAL SERVICES
Address2: 504 CENTRAL AVE
City: DUNKIRK
State: NY
PostalCode: 14048
CountryCode: US
TelephoneNumber: 7163669008
FaxNumber: 7163663158
Other Information
ProviderEnumerationDate: 04/27/2015
LastUpdateDate: 02/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X295131NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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