Provider Demographics
NPI:1457515223
Name:PLAMONDON, GEORGIA A (PA-C)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:A
Last Name:PLAMONDON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:248 PLEASANT ST STE G200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7529
Mailing Address - Country:US
Mailing Address - Phone:603-224-6691
Mailing Address - Fax:603-227-7569
Practice Address - Street 1:248 PLEASANT ST STE G200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7529
Practice Address - Country:US
Practice Address - Phone:603-224-6691
Practice Address - Fax:603-227-7569
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0680363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077629Medicaid