Organization
PLASTIC SURGERY CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J WASSERMANN M.D., MPH, FACS (MEDICAL DIRECTOR)
(803) 779-1200
Entity
Organization
Contact information
Practice address
1220 BLANDING ST, COLUMBIA, SC 29201-2816
(803) 779-1200
(803) 779-1220
Mailing address
1220 BLANDING ST, COLUMBIA, SC 29201-2816
(803) 779-1200
(803) 779-1220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19438
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3494
—
SC
Enumeration date
11/03/2006
Last updated
10/12/2011
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