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NPI Code Detail

MEDICARE: DR. MARK A PLUNKETT M.D. OB/GYN

MEDICARE: DR. MARK A PLUNKETT M.D. OB/GYN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician70932GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659323301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK A PLUNKETT M.D. OB/GYN
Provider Business Mailing Address
First Line : PO BOX 9186
Second Line : WVU DEPT OF OBSTETRICS AND GYNECOLOGY
City : MORGANTOWN
State : WV
Zip : 26506-9186
Country : US
Telephone Number : 304-293-5631
Fax Number : 304-293-2131
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-2605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 06/02/2021

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