Individual
HERBERT S PLOVNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26 CITY HALL MALL, INTERNAL MEDICINE, MEDFORD, MA 02155-4754
(781) 306-5345
(781) 306-5015
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38333
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
38333
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015311
NEIGHBRHOOD HEALTH
MA
05
—
0119873
—
MA
01
—
705817
TUFTS
MA
01
—
M09787
BLUE CROSS
MA
01
—
V534
HARVARD PILGRIM
MA
Enumeration date
06/18/2006
Last updated
06/15/2011
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