Healthcare Provider Details

I. General information

NPI: 1114304029
Provider Name (Legal Business Name): CHRISTOPHER ADAM PLUSKOTA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32800 LORAIN RD STE 2300
NORTH RIDGEVILLE OH
44039-3430
US

IV. Provider business mailing address

125 E BROAD ST
ELYRIA OH
44035-6400
US

V. Phone/Fax

Practice location:
  • Phone: 440-406-5500
  • Fax:
Mailing address:
  • Phone: 440-406-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number012713
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS019196
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: