# GRAND RAPIDS PLASTIC SURGERY PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centre for Plastic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184815417
- **Authorized official:** SCOTT R BRUNDAGE MD (MEMBER)
- **Authorized official phone:** (616) 454-1257

## Contact information

- **Practice address:** 426 MICHIGAN ST, STE 300, GRAND RAPIDS, MI 49503-5609
- **Practice address phone:** (616) 454-1256
- **Practice address fax:** (616) 831-2648
- **Mailing address:** 426 MICHIGAN ST, STE 300, GRAND RAPIDS, MI 49503-5609
- **Mailing address phone:** (616) 454-1256
- **Mailing address fax:** (616) 831-2648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | MI | Yes |

## Other

- **Enumeration date:** 08/01/2007
- **Last updated:** 08/01/2007