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NPI Profile for CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY in COLLEGE PARK, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery |
| NPI # | 1619479201 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/28/2018 | |
| Last updated | 06/01/2022 - About 4 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY
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CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY