Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery |
| NPI Number | 1881609543 |
| LBN Legal business name | RENUE PLASTIC SURGERY, LLC |
| Authorized official | CHARLES MITCHELL - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/30/2006 |
| Last updated | 10/28/2020 - About 6 years ago |
| Identifiers | n/a |
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