Individual
MICHAEL DWAIN PLOOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
635 15TH ST, BARABOO, WI 53913-1502
(608) 356-3942
(608) 356-6047
Mailing address
635 15TH ST, BARABOO, WI 53913-1502
(608) 356-3942
(608) 356-6047
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300576249
—
IL
01
—
16007
DEAN HEALTH PLAN, INC
WI
01
—
1992787535
PHYSICIANS PLLUS
WI
05
—
30407900
—
WI
01
—
57010
WPS
WI
01
—
W005087
CHAMPUS
—
Enumeration date
11/18/2005
Last updated
12/16/2008
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