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Organization

RENAISSANCE PLASTIC SURGERY P.C.

Active
Parent organization
RENAISSANCE PLASTIC SURGERY P.C.
Organization subpart
Yes

Provider details

NPI number
Legal business name
RENAISSANCE PLASTIC SURGERY P.C.
Authorized official
WILLIAM A STEFANI (OWNER)
(586) 779-3030
Entity
Organization

Contact information

Practice address
85 E BIG BEAVER RD, TROY, MI 48083
(586) 779-3030
(586) 779-6733
Mailing address
85 E BIG BEAVER RD, TROY, MI 48083
(586) 779-3030
(586) 779-6733

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MI
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1447266945
NPI
MI
01
1710993217
NPI
MI
05
3078606
MI
05
4134951
MI
01
OEO1025
BLUE CROSS
MI
Enumeration date
01/09/2007
Last updated
07/21/2022
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