Healthcare Provider Details

I. General information

NPI: 1649678475
Provider Name (Legal Business Name): STEVEN T. PLOMARITIS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28001 SCHOENHERR RD SUITE 3
WARREN MI
48088-4396
US

IV. Provider business mailing address

28001 SCHOENHERR RD SUITE 3
WARREN MI
48088-4396
US

V. Phone/Fax

Practice location:
  • Phone: 586-558-9500
  • Fax: 586-558-9501
Mailing address:
  • Phone: 586-558-9500
  • Fax: 586-558-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number5101008748
License Number StateMI

VIII. Authorized Official

Name: DR. STEVEN TITUS PLOMARITIS
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 586-918-9540