Individual
MARK D PLUNKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7525 CALIFORNIA AVE, BOARDMAN, OH 44512-5623
(330) 758-1954
Mailing address
PO BOX 182255, COLUMBUS, OH 43218-2255
(614) 430-5724
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN235006
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139900
ANTHEM
—
05
—
0534667
—
OH
Enumeration date
07/04/2006
Last updated
08/21/2007
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