Individual
MITCHELL MARTIN PLUMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD156412
OR
2086S0129X
Vascular Surgery Physician
Primary
MD156412
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165610
MEDICARE
OR
01
—
4898026
BLUE CROSS
OR
05
—
500647780
—
OR
Enumeration date
06/13/2007
Last updated
05/13/2015
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