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Organization

HAND & PLASTIC SURGERY CENTRE PLC

Active
Other names
Elite Plastic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY ALLEN-STOUFFER (PRACTICE ADMINISTRATOR)
(616) 459-4131
Entity
Organization

Contact information

Practice address
245 CHERRY ST SE, SUITE 302, GRAND RAPIDS, MI 49503-4607
(616) 459-4131
(616) 459-6030
Mailing address
245 CHERRY ST SE, SUITE 302, GRAND RAPIDS, MI 49503-4607
(616) 459-4131
(616) 459-6030

Taxonomy

Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
MI
2086S0122X
Plastic and Reconstructive Surgery Physician
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D16253
BCBS OF MICHIGAN
MI
05
2727404
MI
05
3323257
MI
05
4075832
MI
05
4273703
MI
05
4488298
MI
05
4694901
MI
Enumeration date
12/21/2006
Last updated
02/14/2022
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