# PLASTIC SURGERY CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902887300
- **Authorized official:** SUDARSHAN R REDDY MD FACS (SOLE OWNER OF FACILITY)
- **Authorized official phone:** (586) 263-6050

## Contact information

- **Practice address:** 16100 19 MILE RD, SUITE 100, CLINTON TOWNSHIP, MI 48038-1148
- **Practice address phone:** (586) 263-9657
- **Practice address fax:** (586) 263-0436
- **Mailing address:** 16100 19 MILE RD, SUITE 100, CLINTON TOWNSHIP, MI 48038-1148
- **Mailing address phone:** (586) 263-9657
- **Mailing address fax:** (586) 263-0436

## Taxonomy

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

## Other

- **Enumeration date:** 11/11/2005
- **Last updated:** 08/22/2020