Provider Demographics
NPI:1386660439
Name:PLUNDO MEDICAL ASSOCIATES, OSTEOPATHIC .P.C
Entity Type:Organization
Organization Name:PLUNDO MEDICAL ASSOCIATES, OSTEOPATHIC .P.C
Other - Org Name:PLUNDO-MASTERSON MEDICAL ASSOCIATES, OSTEOPATHIC P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-832-2570
Mailing Address - Street 1:518 PELLIS RD.
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-832-2570
Mailing Address - Fax:724-832-2521
Practice Address - Street 1:518 PELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-832-2570
Practice Address - Fax:724-832-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
152446Medicare PIN