Provider Demographics
NPI:1750350112
Name:PLUNKETT, STEVEN R (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:PLUNKETT
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 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:1400 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4655
Practice Address - Country:US
Practice Address - Phone:704-845-8800
Practice Address - Fax:704-845-8809
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC236402085R0001X
SC138342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2086371OtherUNITED HEALTHCARE
NC26021OtherPARTNERS
NC62138OtherMEDCOST
NC1615558010OtherCIGNA
NC68262OtherBLUE CROSS
SCN23640Medicaid
NC8968262Medicaid
NCC87625Medicare UPIN
SC300012000Medicare ID - Type UnspecifiedRAILROAD
NC212623DMedicare ID - Type UnspecifiedUNIVERSITY RAD ONC CTR
NC212623AMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
NC212623Medicare ID - Type Unspecified
NC212623FMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
SCC876256058Medicare ID - Type UnspecifiedSOUTH CAROLINA MEDICARE