Individual
MR. THOMAS J PLUNKETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5173 IROQUOIS CT, CLARKSTON, MI 48348-3059
(248) 394-0186
Mailing address
5173 IROQUOIS CT, CLARKSTON, MI 48348-3059
(248) 394-0186
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704175416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TP175416
BLUE CROSS OF MI
MI
Enumeration date
08/30/2006
Last updated
07/08/2007
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