Provider Demographics
NPI:1902519689
Name:PLUM, ALIYAH
Entity Type:Individual
Prefix:
First Name:ALIYAH
Middle Name:
Last Name:PLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 1/2 N RANDOLPH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-4131
Mailing Address - Country:US
Mailing Address - Phone:304-614-7672
Mailing Address - Fax:
Practice Address - Street 1:919 1/2 N RANDOLPH AVE APT 2
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4131
Practice Address - Country:US
Practice Address - Phone:304-614-7672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program