Provider Demographics
NPI:1578870887
Name:PLOCHER, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PLOCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OLIVE ST E
Mailing Address - Street 2:APT 4
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4990
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 OLIVE ST E
Practice Address - Street 2:APT 4
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-4990
Practice Address - Country:US
Practice Address - Phone:651-275-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23276207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine