Provider Demographics
NPI:1831265685
Name:PLOTKIN, DAVID HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
Last Name:PLOTKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 OLANDWOOD CT STE 204
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1373
Mailing Address - Country:US
Mailing Address - Phone:301-570-7633
Mailing Address - Fax:301-570-7636
Practice Address - Street 1:3416 OLANDWOOD CT STE 204
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1373
Practice Address - Country:US
Practice Address - Phone:301-570-7633
Practice Address - Fax:301-570-7636
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30498207RS0010X
VA0101056580207RS0012X
MDD52481207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD655102500Medicaid
MD002559Medicare ID - Type UnspecifiedMEDICARE
MD655102500Medicaid