# SOUTHEASTERN FACIAL PLASTIC COSMETIC SURGERY CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Plastic Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467620161
- **Authorized official:** MRS. CYNTHIA COSTA (BUSINESS MANAGER)
- **Authorized official phone:** (843) 722-5904

## Contact information

- **Practice address:** 247 CALHOUN ST, CHARLESTON, SC 29401-1306
- **Practice address phone:** (843) 722-5904
- **Practice address fax:** (843) 722-1564
- **Mailing address:** 247 CALHOUN ST, CHARLESTON, SC 29401-1306
- **Mailing address phone:** (843) 722-5904
- **Mailing address fax:** (843) 722-1564

## Taxonomy

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

## Other

- **Enumeration date:** 02/15/2008
- **Last updated:** 02/15/2008