Provider Demographics
NPI:1629030051
Name:RICHARD M PLOTZKER, M.D.
Entity Type:Organization
Organization Name:RICHARD M PLOTZKER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:PLOTZKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-478-6525
Mailing Address - Street 1:1602 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6208
Mailing Address - Country:US
Mailing Address - Phone:302-633-5840
Mailing Address - Fax:302-633-5844
Practice Address - Street 1:3411 SILVERSIDE RD
Practice Address - Street 2:WELDIN BLDG, SUITE 109
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-478-6525
Practice Address - Fax:302-478-6530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1990034409207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000226201Medicaid
DE0000226201Medicaid
DEE44405Medicare UPIN
DE=========OtherBCBS OF DE