Provider Demographics
NPI:1407870215
Name:PLOTNICK, EDWIG K (MD)
Entity Type:Individual
Prefix:
First Name:EDWIG
Middle Name:K
Last Name:PLOTNICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 COLESVILLE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3921
Mailing Address - Country:US
Mailing Address - Phone:301-588-4260
Mailing Address - Fax:301-588-4261
Practice Address - Street 1:8737 COLESVILLE RD STE 304
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3921
Practice Address - Country:US
Practice Address - Phone:301-588-4260
Practice Address - Fax:301-588-4261
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD308522084P0800X
MDD00440532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98834Medicare UPIN
490386Medicare ID - Type Unspecified