Basic Information
Provider Information
NPI: 1164456166
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLATH
FirstName: DIANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 HOUGHTON AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 48602
CountryCode: US
TelephoneNumber: 9895836800
FaxNumber: 9895836955
Practice Location
Address1: 1632 STONE ST
Address2:  
City: SAGINAW
State: MI
PostalCode: 48602
CountryCode: US
TelephoneNumber: 9895836800
FaxNumber: 9895836955
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 04/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XDP066583MIY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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