MEDICARE: DR. MARK CHRISTOPHER PLUYM 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	207RP1001X	Pulmonary Disease Physician	042.0018193	VT

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942597489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK CHRISTOPHER PLUYM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 905
Second Line	:
City	:	ST JOHNSBURY
State	:	VT
Zip	:	05819-0905
Country	:	US
Telephone Number	:	802-748-8141
Fax Number	:	802-748-4098

Provider Business Practice Location Address
First Line	:	1290 HOSPITAL DR LOWR LEVEL
Second Line	:
City	:	ST JOHNSBURY
State	:	VT
Zip	:	05819-9205
Country	:	US
Telephone Number	:	802-745-6800
Fax Number	:	802-748-7451

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

Provider Enumeration Date	:	07/05/2011
Last Update Date	:	07/14/2025

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