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NPI Code Detail

MEDICARE: MRS. MARCELLA PLUTH MS, LP

MEDICARE: MRS. MARCELLA PLUTH MS, LP
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
1103T00000XPsychologistLP 2083MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11020045OTHERMNPREFERRED ONE
255P77ROOTHERMNBLUE CROSS BLUE SHIELD
3128337OTHERMNUCARE
4HP37852OTHERMNHEALTH PARTNERS
562-63834OTHERMNMEDICA
620659OTHERMNSIOUX VALLEY HEALTH
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962414144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARCELLA PLUTH MS, LP
Provider Business Mailing Address
First Line : 3395 PLYMOUTH RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-3765
Country : US
Telephone Number : 952-939-0396
Fax Number : 952-548-8760
Provider Business Practice Location Address
First Line : 3395 PLYMOUTH RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-3765
Country : US
Telephone Number : 952-939-0396
Fax Number : 952-548-8760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 03/20/2018

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