| Pleasant Valley Primary Care | |
|
20311 Lappans Rd Ste 100 Boonsboro MD 21713-2086 | |
| (301) 573-9453 | |
| Not Available |
| Full Name | Pleasant Valley Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 20311 Lappans Rd Ste 100, Boonsboro, Maryland |
| Authorized Official Name and Position | Jessica Roelkey (OWNER) |
| Authorized Official Contact | 3015739453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pleasant Valley Primary Care 20311 Lappans Rd Ste 100 Boonsboro MD 21713-2086 Ph: (301) 799-1098 | Pleasant Valley Primary Care 20311 Lappans Rd Ste 100 Boonsboro MD 21713-2086 Ph: (301) 573-9453 |
| NPI Number | 1346962149 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 02/02/2023 |
| Certification Date | 02/02/2023 |
| Medicare PECOS PAC ID | 4688047954 |
|---|---|
| Medicare Enrollment ID | O20230307002830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346962149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | David Roelkey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497927743 PECOS PAC ID: 6305019431 Enrollment ID: I20210629000291 |
| Provider Name | Jessica Roelkey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619390424 PECOS PAC ID: 2769614601 Enrollment ID: I20230403000791 |
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