Provider Demographics
NPI:1407898240
Name:PLEET, DAVID LOWENER (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LOWENER
Last Name:PLEET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-739-5676
Mailing Address - Fax:413-739-2278
Practice Address - Street 1:2150 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3300
Practice Address - Country:US
Practice Address - Phone:413-739-5676
Practice Address - Fax:413-739-2278
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54172207RG0100X
CT028964207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15466OtherHEALTH NEW ENGLAND
MA054172OtherTUFTS HEALTH PLAN
MA6193218Medicaid
CT010054172MA01OtherBLUE CROSS BLUE SHIELD CT
MAJ04231OtherBLUE CROSS BLUE SHIELD
CT010028964CT01OtherBLUE CROSS BLUE SHIELD CT
MAJ04231OtherBLUE CROSS BLUE SHIELD
A68250Medicare UPIN