National Provider Identifier Database

NORTH STAR PLASTIC SURGERY LLC
Plastic and Reconstructive Surgery


Contact Information

NORTH STAR PLASTIC SURGERY LLC
1919 LATHROP ST STE 205
FAIRBANKS, AK99701-5942
Phone: 907-416-5611
Fax:
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for NORTH STAR PLASTIC SURGERY LLC

NPI Number 1417653569
Legal business name
LBN
NORTH STAR PLASTIC SURGERY LLC
Authorized official ERICK MARTELL - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 01/31/2023
Last updated 09/13/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AK Medicaid: 1720992

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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