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Organization

JOSEPH ADVANCED FACIAL PLASTIC SURGERY, PLLC

Active
Other names
JOSEPH Advanced Oculofacial Plastic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHANNON S. JOSEPH MD (MEMBER)
(947) 217-3223
Entity
Organization

Contact information

Practice address
3940 JOHN R RD, TROY, MI 48083-5688
(947) 217-3223
Mailing address
3435 LIVERNOIS RD, TROY, MI 48083-5063
(947) 217-3223
(248) 817-3994

Taxonomy

Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
207YS0123X
Facial Plastic Surgery Physician

Other

Enumeration date
01/07/2022
Last updated
07/07/2024
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