Provider Demographics
NPI:1356403679
Name:PLOTSKY MEDICAL ASSOCIATES PC
Entity type:Organization
Organization Name:PLOTSKY MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PLOTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-330-0661
Mailing Address - Street 1:15225 SHADY GROVE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-330-0661
Mailing Address - Fax:301-977-6940
Practice Address - Street 1:15225 SHADY GROVE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-330-0661
Practice Address - Fax:301-977-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00246Medicare PIN