MEDICARE: MARK C PLUMBY M.D.

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	207X00000X	Orthopaedic Surgery Physician	27732	WV
2	207X00000X	Orthopaedic Surgery Physician	35.134639	OH
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	27732	WV
4	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	35.134639	OH

General Provider Information

NPI Number	:	1518344092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK C PLUMBY M.D.

Provider Business Mailing Address
First Line	:	611 2ND ST
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-2123
Country	:	US
Telephone Number	:	740-373-8756
Fax Number	:	740-373-0091

Provider Business Practice Location Address
First Line	:	611 2ND ST
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-2123
Country	:	US
Telephone Number	:	740-373-8756
Fax Number	:	740-373-0091

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

Provider Enumeration Date	:	05/04/2015
Last Update Date	:	07/02/2025

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