Basic Information
| Provider Information | |||||||||
| NPI: | 1770504276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLITMAN | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 607 IDOL ST | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272627804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022407 | ||||||||
| FaxNumber: | 3368022401 | ||||||||
| Practice Location | |||||||||
| Address1: | 624 QUAKER LN | ||||||||
| Address2: | SUITE 100D | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272623832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022090 | ||||||||
| FaxNumber: | 3368022091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 9501379 | NC | X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 9501379 | NC | X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 8968233 | 05 | NC | MEDICAID |