MEDICARE: IRWIN PLISCO M.D.

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	207R00000X	Internal Medicine Physician	R8E05	MO
2	207R00000X	Internal Medicine Physician	24734	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	127484	OTHER	MO	GHP
2	0400525	OTHER	MO	UHC
3	102101	OTHER	MO	HEALTHLINK
4	4040631	OTHER	MO	AETNA
5	6400	OTHER	MO	BCBS
6	C04130	OTHER	MO	EXCLUSIVE CHOICE
7	000000010029	OTHER	MO	ESSENCE
8	000000012461	OTHER	MO	ESSENCE ST CHARLES
9	2267138	OTHER	MO	AETNA US
10	A10442	OTHER	MO	MERCY

General Provider Information

NPI Number	:	1871574525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRWIN PLISCO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 23340
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63156-3340
Country	:	US
Telephone Number	:	314-839-4554
Fax Number	:	314-837-0047

Provider Business Practice Location Address
First Line	:	1224 GRAHAM RD
Second Line	:	SUITE 2003
City	:	FLORISSANT
State	:	MO
Zip	:	63031-8028
Country	:	US
Telephone Number	:	314-839-4554
Fax Number	:	314-837-0047

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	12/08/2011

Similar Medicare Providers

1871599811 — DR. SHARI LEWIS KAMINSKY DPM
Practice Location Address:

1224 GRAHAM RD , SUITE 3010
FLORISSANT, MO
63031-8028

Practice Phone: 314-355-0074
Practice Fax: 314-355-0337

1447212626 — CHINDA ROJANASATHIT M.D.
Practice Location Address:

1224 GRAHAM RD , SUITE 1113
FLORISSANT, MO
63031-8028

Practice Phone: 314-839-4500
Practice Fax: 314-839-8521

1326001009 — DR. KEVIN J MURPHY MD
Practice Location Address:

1224 GRAHAM RD , STE 1103
FLORISSANT, MO
63031-8028

Practice Phone: 314-837-0405
Practice Fax: 314-395-7289

1144336058 — CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
Practice Location Address:

1224 GRAHAM RD
FLORISSANT, MO
63031-8028

Practice Phone: 314-953-6740
Practice Fax: 314-953-6921

1891807137 — DAVID A. GLASER MD
Practice Location Address:

1224 GRAHAM RD , SUITE 3011
FLORISSANT, MO
63031-8028

Practice Phone: 314-839-1211
Practice Fax:

1851403190 — CARLA TERRITO
Practice Location Address:

1224 GRAHAM RD , SUITE 3011
FLORISSANT, MO
63031-8028

Practice Phone: 314-839-1211
Practice Fax:

Directions to “ IRWIN PLISCO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.