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Contact Information

RENAISSANCE PLASTIC SURGERY PC
10293 N MERIDIAN ST
SUITE 200
INDIANAPOLIS, IN46290
 Phone: 317-575-9152
 Fax: 317-575-9281
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for RENAISSANCE PLASTIC SURGERY PC

NPI Number 1407914567
LBN Legal business name RENAISSANCE PLASTIC SURGERY PC
Authorized official JOSEPH FATA - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2006
Last updated 06/27/2013 - About 13 years ago
Identifiers
IN Medicaid 100120400A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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