Provider Demographics
NPI:1245437045
Name:PLASNER, SCOTT S (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:S
Last Name:PLASNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:201-612-4963
Practice Address - Fax:215-612-4532
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012726207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07645OtherHEALTH PARTNERS
PA1019644430001Medicaid
PA30044315OtherKEYSTONE MERCY
PA2855044000OtherPERSONAL CHOICE
PA10196444430003Medicaid
PA1019644430002Medicaid
PA1977292OtherHIGHMARK BLUE SHIELD
PA2855044000OtherKEYSTONE IBC
PA114622JL1Medicare PIN