Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 128528 | OH |
Y | 2080P0202X | Pediatric Cardiologist | 11260386-8905 | UT |
N | 2080P0202X | Pediatric Cardiologist | 128528 | OH |
N | 2080P0202X | Pediatric Cardiologist | 54407 | AZ |
NPI | 1013144450 |
---|---|
Provider Name | Michelle Ploutz |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2009 |
Last Update Date | 11/11/2021 |