Provider Demographics
NPI:1881768430
Name:PLZAK, LOUIS F III (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:F
Last Name:PLZAK
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1055 RIBAUT RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5423
Mailing Address - Country:US
Mailing Address - Phone:843-524-7607
Mailing Address - Fax:843-524-6737
Practice Address - Street 1:1055 RIBAUT RD
Practice Address - Street 2:SUITE 10
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5423
Practice Address - Country:US
Practice Address - Phone:843-524-7607
Practice Address - Fax:843-524-6737
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC23117208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571087172OtherAETNA
SC571087172OtherBLUE CROSS
SC571087172OtherBLUE CROSS
SCH488016616Medicare ID - Type UnspecifiedMEDICARE