Provider Demographics
NPI:1851634331
Name:PLACKO, DOUG ADAM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DOUG
Middle Name:ADAM
Last Name:PLACKO
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:420 E NORTH AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4746
Mailing Address - Country:US
Mailing Address - Phone:412-359-3683
Mailing Address - Fax:412-359-3373
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3683
Practice Address - Fax:412-359-3373
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA056043363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical