Organization
PLASTIC SURGERY SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JOHN LIVINGSTON M.D. (OWNER)
(616) 826-0374
Entity
Organization
Contact information
Practice address
2060 E. PARIS, SUITE 110, GRAND RAPIDS, MI 49546
(616) 826-0374
Mailing address
2060 E. PARIS, SUITE 110, GRAND RAPIDS, MI 49546
(616) 826-0374
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301061751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689624017
INDIVIDUAL NPI #
MI
Enumeration date
11/05/2008
Last updated
11/05/2008
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