Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery |
| NPI # | 1023203916 |
| LBN Legal business name | OFFICE SURGERY CENTER |
| Authorized official | SCOTT NEWMAN - (MEDICAL DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/13/2007 |
| Last updated | 09/13/2007 - About 19 years ago |
| Identifiers | n/a |
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