Organization · Type 2 NPI
Great Lakes Plastic Surgery Center
Plastic and Reconstructive Surgery Physician · Traverse City, MI
NPI number
1972795334
Active
Practice location
5085 Anna Dr
Traverse City, MI 49684-9691
Fax (231) 935-0099
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | None listed |
| Nurse Practitioner | 363L00000X | None listed |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
Other plastic and reconstructive surgery physician providers in Traverse City
About NPI 1972795334
Great Lakes Plastic Surgery Center's National Provider Identifier is 1972795334, issued on Aug 9, 2007. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Traverse City, MI. The record was last updated on Aug 18, 2009.