Provider Demographics
NPI:1831215169
Name:PLOTKIN, LARRY H (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:H
Last Name:PLOTKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 MEADOWRIDGE CENTER DR
Mailing Address - Street 2:STE K
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6089
Mailing Address - Country:US
Mailing Address - Phone:410-379-8300
Mailing Address - Fax:
Practice Address - Street 1:6305C WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5348
Practice Address - Country:US
Practice Address - Phone:410-379-8300
Practice Address - Fax:410-379-0228
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
6978412004OtherASHN
MD101022OtherJHHC
DD0972OtherMEDICARE RR
MH22281OtherALLIANCE
2736388OtherAETNA
204558300OtherMAMD
MDS765ALOtherBSMD
DCE466OtherBSDC
MDS756OtherMEDICARE ID-TYPE UNSPECIF
2736388OtherAETNA