Healthcare Provider Details

I. General information

NPI: 1831215169
Provider Name (Legal Business Name): LARRY H PLOTKIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305C WASHINGTON BLVD
ELKRIDGE MD
21075-5348
US

IV. Provider business mailing address

6010 MEADOWRIDGE CENTER DR STE K
ELKRIDGE MD
21075-6089
US

V. Phone/Fax

Practice location:
  • Phone: 410-379-8300
  • Fax: 410-379-0228
Mailing address:
  • Phone: 410-379-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS01692
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: