1952463671 NPI number — DR. PATRICIA ANN PLOPA PH.D.

Table of content: DR. PATRICIA ANN PLOPA PH.D. (NPI 1952463671)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952463671 NPI number — DR. PATRICIA ANN PLOPA PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLOPA
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

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:
1952463671
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:
4655 PICKERING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLOOMFIELD HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48301-3631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-737-6417
Provider Business Mailing Address Fax Number:
248-737-6417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4655 PICKERING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLOOMFIELD HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48301-3631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-737-6417
Provider Business Practice Location Address Fax Number:
248-737-6417
Provider Enumeration Date:
12/16/2006

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: 103TC0700X , with the licence number:  6301 002100 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1600-2949 . This is a "AMERICAN PSYCHOLOGICAL AS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 23357 . This is a "NATIONAL REGISTER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 6301 002100 . This is a "PSYCHOLOGIST LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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