1013050467 NPI number — DR. JOEL FRANKLIN PLEETER M.D.

Table of content: DR. JOEL FRANKLIN PLEETER M.D. (NPI 1013050467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013050467 NPI number — DR. JOEL FRANKLIN PLEETER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLEETER
Provider First Name:
JOEL
Provider Middle Name:
FRANKLIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013050467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 HOOKS LN
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
PIKESVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21208-1617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-653-6500
Provider Business Mailing Address Fax Number:
410-653-6511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 HOOKS LN
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
PIKESVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21208-1617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-653-6500
Provider Business Practice Location Address Fax Number:
410-653-6511
Provider Enumeration Date:
02/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D46131 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)