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General NPI Number Information
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NPI Number | 1780520981
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Entity Type | Organization
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Legal Business Name | PROVIDER PLEXUS, INC.
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 251 LITTLE FALLS DR
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City | WILMINGTON
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State | DE
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Zip | 19808-1674
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Country | US
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Telephone | 866-983-9023
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 SAINT JOSEPHS CT
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City | BRENTWOOD
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State | TN
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Zip | 37027-1806
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Country | US
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Telephone | 414-469-9353
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL ARTEAGA
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Credential | MD
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Telephone | 414-469-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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