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Individual

DR. MARC A. PLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 725-1226
(540) 857-5306
Mailing address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 725-1226
(540) 857-5306

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0103000356
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100256000
MEDICAID OF WEST VIRGINIA
VA
01
1184695249
AETNA
VA
05
1184695249
VA
01
371194700
BLACK LUNG
VA
01
540506332108
TRICARE/CHAMPUS
VA
01
P00825874
RAILROAD MEDICARE
VA
Enumeration date
01/27/2006
Last updated
03/17/2014
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