Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery |
| NPI # | 1356007264 |
| LBN Legal business name | CSRA PLASTIC SURGERY ASSOCIATES PC |
| Authorized official | SARAH CRANDALL - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/15/2021 |
| Last updated | 11/15/2021 - About 5 years ago |
| Identifiers | n/a |
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