Individual
MICHAEL ALAN PLASTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3231 S NATIONAL AVE, SUITE 200, SPRINGFIELD, MO 65807-7304
(417) 885-0823
(417) 890-4178
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2011002474
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
01/31/2011
Last updated
06/02/2015
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