Healthcare Provider Details

I. General information

NPI: 1558505370
Provider Name (Legal Business Name): MARSHALL PLAUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 ROCKLEDGE DR ROOM 6421, MSC 6601
BETHESDA MD
20892-6601
US

IV. Provider business mailing address

6610 ROCKLEDGE DR ROOM 6421, MSC 6601
BETHESDA MD
20892-6601
US

V. Phone/Fax

Practice location:
  • Phone: 301-435-4425
  • Fax: 301-402-0175
Mailing address:
  • Phone: 301-435-4425
  • Fax: 301-402-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0010458
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: