Individual
DEREK O PLOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5222
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
193884
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
202208560CRNA-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659834554
—
WI
Enumeration date
04/09/2019
Last updated
05/11/2026
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