MEDICARE: DR. MICHAEL T. PLISHCHUK D.P.M.

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist	25MD00293600	NJ
2	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00293600	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1760675789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL T. PLISHCHUK D.P.M.

Provider Business Mailing Address
First Line	:	54 BEY LEA RD
Second Line	:	SUITE 1
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2978
Country	:	US
Telephone Number	:	732-505-4500
Fax Number	:	732-505-9787

Provider Business Practice Location Address
First Line	:	54 BEY LEA RD
Second Line	:	SUITE 1
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2978
Country	:	US
Telephone Number	:	732-505-4500
Fax Number	:	732-505-9787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	04/23/2013

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Directions to “ DR. MICHAEL T. PLISHCHUK D.P.M.” Practice Location

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