Healthcare Provider Details

I. General information

NPI: 1770504276
Provider Name (Legal Business Name): JONATHAN D. PLITMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 QUAKER LN SUITE 100D
HIGH POINT NC
27262-3832
US

IV. Provider business mailing address

607 IDOL ST
HIGH POINT NC
27262-7804
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2090
  • Fax: 336-802-2091
Mailing address:
  • Phone: 336-802-2407
  • Fax: 336-802-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number9501379
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number9501379
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier8968233
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: