Provider Demographics
NPI:1780664342
Name:PLAISIER, BRIAN R (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:R
Last Name:PLAISIER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:BOX 39
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:BRONSONS TRAUMA AND EMERGENCY SURGERY SUITE E178
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-6022
Practice Address - Fax:269-341-8244
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010738712086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4113227Medicaid
F27145Medicare UPIN
MIOC97618062Medicare ID - Type Unspecified