Provider Demographics
NPI:1881629145
Name:PLAIN, GEORGE BAKER (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:BAKER
Last Name:PLAIN
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 1:300 WHITE SPRUCE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623
Mailing Address - Country:US
Mailing Address - Phone:585-424-5600
Mailing Address - Fax:585-427-2712
Practice Address - Street 1:300 WHITE SPRUCE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623
Practice Address - Country:US
Practice Address - Phone:585-424-5440
Practice Address - Fax:585-427-2712
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184316207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01302432Medicaid
NY10668BMedicare ID - Type Unspecified
NY01302432Medicaid