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Contact Information

GRAND RAPIDS PLASTIC SURGERY PLC
2060 EAST PARIS AVE SE
SUITE 150
GRAND RAPIDS, MI49546
 Phone: 616-454-1256
 Fax: 616-454-0308
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GRAND RAPIDS PLASTIC SURGERY PLC

NPI # 1760654602
LBN Legal business name GRAND RAPIDS PLASTIC SURGERY PLC
Authorized official CAROL FEWLESS - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/01/2008
Last updated 07/31/2013 - About 13 years ago
Identifiers
MI Other 0D11002 BCBS
MI Other B0001 BCN
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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