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1407837057

NPI Code Detail

MEDICARE: DR. ELSIE DIANE PLYLER MD

MEDICARE: DR. ELSIE DIANE PLYLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301049498	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0100174	OTHER	MI	PHYSICIANS HEALTH PLAN
2	4062824	OTHER	MI	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	201486	OTHER	MI	MCLAREN HEALTH ADVANTAGE
6	201486	OTHER	MI	HEALTH ADVANTAGE NETWORK
7	E49554	OTHER	MI	HEALTH NET FED SERVICES
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407837057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELSIE DIANE PLYLER MD

Provider Business Mailing Address
First Line	:	401 S BALLENGER HWY
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3638
Country	:	US
Telephone Number	:	810-342-1000
Fax Number	:	810-342-1590

Provider Business Practice Location Address
First Line	:	2316 S CEDAR ST
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-3152
Country	:	US
Telephone Number	:	517-702-4130
Fax Number	:	517-702-4139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. ELSIE DIANE PLYLER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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