Individual
GEORGE WEBB PLONK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18698
NC
2086S0102X
Surgical Critical Care Physician
18698
NC
2086S0129X
Vascular Surgery Physician
Primary
18698
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1804062000
—
WV
01
—
20051994
RR MEDICARE
—
01
—
29366
MEDCOST
—
01
—
4665730
AETNA
—
01
—
68249
BCBS
—
05
—
7300948
—
VA
01
—
8149
PARTNERS
—
05
—
8968249
—
NC
05
—
Q18698
—
SC
Enumeration date
12/13/2005
Last updated
11/12/2010
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