Healthcare Provider Details
I. General information
NPI: 1881840908
Provider Name (Legal Business Name): PLINY INPATIENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2008
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
95 CAMPUS AVE # 97 SUITE 7
LEWISTON ME
04240-6055
US
IV. Provider business mailing address
1717 MAIN ST SUITE 5200
DALLAS TX
75201-4612
US
V. Phone/Fax
- Phone: 207-777-4677
- Fax:
- Phone: 214-712-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGEL
ISCOVICH
Title or Position: OWNER
Credential: MD
Phone: 214-712-2000