Provider Demographics
NPI:1083697528
Name:PLENSDORF, SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:PLENSDORF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1184
Mailing Address - Country:US
Mailing Address - Phone:717-786-7383
Mailing Address - Fax:717-786-8635
Practice Address - Street 1:540 NORTH DUKE STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2374
Practice Address - Country:US
Practice Address - Phone:717-786-7383
Practice Address - Fax:717-786-8635
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD458301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5954775OtherAETNA
MIC6555OtherMCARE
MI010B56026OtherCOMMUNITY BLUE PPO
MI253047OtherMCLAREN HEALTH PLAN
MI253047OtherHEALTH ADVANTAGE NETWORK
MI4125157Medicaid
MI010B56026OtherBLUE CROSS BLUE SHIELD
MI0802504591OtherBLUE CROSS BLUE SHIELD
MI010B56026OtherBLUE CHOICE
MI010B56026OtherBLUE CARE NETWORK
MI0985515OtherHEALTHPLUS
MIG28639OtherHEALTH NET FEDERAL SERVIC
MIG28639OtherHAP
MIG28639Medicare UPIN
MIOB56026098Medicare ID - Type Unspecified