Provider Demographics
NPI:1104818004
Name:PLAVNER, VICTOR M (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:M
Last Name:PLAVNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:1509 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2742
Practice Address - Country:US
Practice Address - Phone:410-757-7600
Practice Address - Fax:410-626-8043
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0028686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0475304OtherAETNA CAPITATED
MD915381100Medicaid
MD231578OtherMAMSI SPECIALIST
MD024070OtherJHHC PROVIDER NUMBER
MD1295371OtherCIGNA PIN
MD419295-01OtherCAREFIRST MD RENDERING
MD80083128OtherRAILROAD MEDICARE
MD4313164OtherAETNA FEE FOR SERVICE
MD7605-0009OtherCAREFIRST BLUECHOICE
MD831578OtherMAMSI PRIMARY CARE
MDP11948OtherCAREFIRST MPOS
MD024070OtherJHHC PROVIDER NUMBER
MD0475304OtherAETNA CAPITATED