Healthcare Provider Details

I. General information

NPI: 1356458319
Provider Name (Legal Business Name): GEORGE A PLIAGAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4275 BURNHAM AVE STE 102
LAS VEGAS NV
89119-5488
US

IV. Provider business mailing address

1525 E BELTLINE AVE NE STE 101
GRAND RAPIDS MI
49525-4598
US

V. Phone/Fax

Practice location:
  • Phone: 702-878-8346
  • Fax: 702-259-0205
Mailing address:
  • Phone: 616-447-8220
  • Fax: 616-710-4048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD20942
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD20942
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: