Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 01033811 | IN |
NPI | 1013939354 |
---|---|
Provider Name | Dr. John F. Plascak |
First Address | Greenwood, IN 46143-7241 |
Second Address | West Lafayette, IN 47906-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 13/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000877152 | ANTHEM (01) | |
100192210 | (05) | IN |
D95626 | (02) | IN |