Provider Demographics
NPI:1891134276
Name:PLAVI, KATLIN R (PA)
Entity Type:Individual
Prefix:
First Name:KATLIN
Middle Name:R
Last Name:PLAVI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATLIN
Other - Middle Name:
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 9238
Mailing Address - Street 2:UNIVERSITY HEALTH ASSOCIATES WVU DEPARTMENT OF SURGERY
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9238
Mailing Address - Country:US
Mailing Address - Phone:304-293-5169
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:WVU DEPARTMENT OF SURGERY
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-293-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1891134276Medicaid