National Provider Identifier Database

PLASTIC SURGERY OF KALAMAZOOPC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

PLASTIC SURGERY OF KALAMAZOO,PC
7901 SOUTH 12TH STREET
SUITE 100
PORTAGE, MI49024
Phone: 269-372-3000
Fax: 269-372-3500
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for PLASTIC SURGERY OF KALAMAZOO,PC

NPI Number 1245452481
Legal business name
LBN
PLASTIC SURGERY OF KALAMAZOO,PC
Authorized official ROSE JOHNSON - (MANAGER, PATIENT ACCOUNTS)
Entity Organization
Organization subpart No
Enumeration date 05/03/2007
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • MI Medicaid: 1920114
  • MI Medicaid: 1997100

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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