David Roger Plattes, MD
Individual provider Active NPI Family Medicine Physician · Longville, MN
NPI 1194700682 · NPPES record last updated Jul 5, 2010
Key facts
- NPI
- 1194700682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 29951 (MN)
- Practice address
- 180 Jordan LN
Longville Lakes Clinic
Longville, MN 56655-3164 - Phone
- (218) 363-3300
- Fax
- (218) 363-2233
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 29951 | MN | Yes |
Addresses
Primary practice location
180 Jordan LN
Longville Lakes Clinic
Longville, MN 56655-3164
Mailing address
180 Jordan LN
Longville, MN 56655-3164
Phone (218) 363-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 530763500 | Medicaid | MN |
Other providers in Longville, MN
- Connor Daudt
- David W Laposky
- Elizabeth Ann Miles
- Nis Pharmacy Services LTD
- Nis Pharmacy Services, LTD
All providers in Longville, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.