Provider Demographics
NPI:1992694681
Name:PLUME, ADDISON MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ADDISON
Middle Name:MARIE
Last Name:PLUME
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 GLEN ARM RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9302
Mailing Address - Country:US
Mailing Address - Phone:410-456-3483
Mailing Address - Fax:
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY UNIT 212
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4476
Practice Address - Country:US
Practice Address - Phone:302-645-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0012300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant