Provider Demographics
NPI:1235346578
Name:PLIZGA, LINDA ANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANNE
Last Name:PLIZGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1506
Mailing Address - Country:US
Mailing Address - Phone:313-264-6460
Mailing Address - Fax:313-640-0909
Practice Address - Street 1:648 SAINT CLAIR ST
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1506
Practice Address - Country:US
Practice Address - Phone:313-264-6460
Practice Address - Fax:313-640-0909
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017033207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION71840OtherMEDICARE PTN
MION71840075OtherMEDICARE
MI1235346578Medicaid