Provider Demographics
NPI:1184695249
Name:PLATT, MARC A (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:PLATT
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:3 RIVERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4955
Mailing Address - Country:US
Mailing Address - Phone:540-725-1226
Mailing Address - Fax:540-857-5306
Practice Address - Street 1:3 RIVERSIDE CIR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4955
Practice Address - Country:US
Practice Address - Phone:540-725-1226
Practice Address - Fax:540-857-5306
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0103000356213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1184695249OtherAETNA
VA1184695249OtherCIGNA
VA1184695249OtherVIRGINIA HEALTH NETWORK
VA540506332108OtherTRICARE/CHAMPUS
VA1184695249OtherHEALTHKEEPERS PLUS
VAP00825874OtherRAILROAD MEDICARE
VA1184695249OtherGATEWAY
VA371194700OtherBLACK LUNG
VA1184695249OtherOPTIMA HEALTH PLAN
VA1184695249OtherINTOTAL
VA1184695249OtherUMWA
VA1184695249OtherANTHEM
VA1184695249OtherMAJESTACARE
VA1184695249OtherHUMANA MEDICARE
VA1184695249Medicaid
VA0100256000OtherMEDICAID OF WEST VIRGINIA
VA1184695249OtherVA PREMIER
VA1184695249OtherHEALTHKEEPERS
VA1184695249OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1184695249OtherUNITED HEALTHCARE
VA1184695249OtherOPTIMA HEALTH PLAN
VA1184695249OtherVIRGINIA HEALTH NETWORK