1407848302 NPI number — ASTRIDA A. PLUCIS M.D.

Table of content: ASTRIDA A. PLUCIS M.D. (NPI 1407848302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407848302 NPI number — ASTRIDA A. PLUCIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLUCIS
Provider First Name:
ASTRIDA
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PLUCIS-TURKOPULIS
Provider Other First Name:
ASTRIDA
Provider Other Middle Name:
ANTONIA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1407848302
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
92 W WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-263-2540
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
92 W WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-2432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-263-2540
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D0023455 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7605-0040 . This is a "CAREFIRST BLUECHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 831586 . This is a "MAMSI PRIMARY CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4313159 . This is a "AETNA FEE FOR SERVICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P11947 . This is a "CAREFIRST MPOS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: D0023455 . This is a "MHIP PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 024100 . This is a "JHHC PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 231586 . This is a "MAMSI SPECIALIST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 01-00597 . This is a "UHC PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1404109 . This is a "CIGNA PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0475278 . This is a "AETNA CAPITATED" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 419305-01 . This is a "CAREFIRST MD RENDERING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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