Provider Demographics
NPI:1700142668
Name:PLANCHER, JOAO MC-ONEIL NICOLAS MOISE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAO MC-ONEIL
Middle Name:NICOLAS MOISE
Last Name:PLANCHER
Suffix:
Gender:M
Credentials:MD
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 102632
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2632
Mailing Address - Country:US
Mailing Address - Phone:404-778-7402
Mailing Address - Fax:
Practice Address - Street 1:677 CHURCH STREET
Practice Address - Street 2:NEURO BOX
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-422-2326
Practice Address - Fax:770-422-7797
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200055572084N0400X
MT789802084N0400X
MI43011191732084N0400X
ORMD1936782084N0400X
GA0756492084N0400X, 2084A2900X
NH198312084N0400X
PAMD4775412084N0400X
TXT44562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3119274Medicaid