Healthcare Provider Details

I. General information

NPI: 1245265735
Provider Name (Legal Business Name): NANCY K PLOURDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 REECEVILLE RD
COATESVILLE PA
19320-1542
US

IV. Provider business mailing address

410 GROUND HOG COLLEGE RD
WEST CHESTER PA
19382-6761
US

V. Phone/Fax

Practice location:
  • Phone: 610-383-8119
  • Fax:
Mailing address:
  • Phone: 610-383-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD024897E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: