Provider Demographics
NPI:1932173408
Name:PLAUTZ, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PLAUTZ
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 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-4629
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:70 MEDICAL CENTER CIR
Practice Address - Street 2:SUITE 104
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-245-7010
Practice Address - Fax:540-245-7011
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238265207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10000431OtherOPTIMA
VA5642978OtherFIRST HEALTH
VA182229OtherANTHEM
VA010189977Medicaid
VA325706OtherSOUTHERN HEALTH
VA5642978OtherFIRST HEALTH
VA182229OtherANTHEM
VA10000431OtherOPTIMA
VA325706OtherSOUTHERN HEALTH