Healthcare Provider Details

I. General information

NPI: 1467426239
Provider Name (Legal Business Name): DAVID P PLETZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11530 ALLISONVILLE ROAD STE 190
FISHERS IN
46038-1862
US

IV. Provider business mailing address

250 N SHADELAND AVE STE 130 IU HEALTH PHYSICIANS
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-678-3850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01034308A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: