Healthcare Provider Details

I. General information

NPI: 1346082997
Provider Name (Legal Business Name): MR. DMYTRO PLYUTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 S 9TH ST APT 1005
MINNEAPOLIS MN
55402-3133
US

IV. Provider business mailing address

36 S 9TH ST APT 1005
MINNEAPOLIS MN
55402-3133
US

V. Phone/Fax

Practice location:
  • Phone: 206-579-8895
  • Fax:
Mailing address:
  • Phone: 206-579-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: