1063443471 NPI number — PLANAS AND ASSOCIATES,MD,PC

Table of content: (NPI 1063443471)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063443471 NPI number — PLANAS AND ASSOCIATES,MD,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANAS AND ASSOCIATES,MD,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1063443471
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7068
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23707-0068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-686-3520
Provider Business Mailing Address Fax Number:
757-686-0230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 RIVERVIEW AVE
Provider Second Line Business Practice Location Address:
STE 500
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23510-1065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-686-3508
Provider Business Practice Location Address Fax Number:
757-686-0541
Provider Enumeration Date:
07/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PLANAS
Authorized Official First Name:
ROQUE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
757-233-8905

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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