Organization
PLASTIC SURGICAL CENTER
Active
Other names
Aesthetic Consultants of Iowa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E GRADO M.D. (OWNER/PHYSICIAN)
(319) 393-1902
Entity
Organization
Contact information
Practice address
3705 RIVER RIDGE DR NE, CEDAR RAPIDS, IA 52402-7596
(319) 393-1902
(319) 393-1867
Mailing address
3705 RIVER RIDGE DR NE, CEDAR RAPIDS, IA 52402-7596
(319) 393-1902
(319) 393-1867
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
24782
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0229138
—
IA
Enumeration date
10/11/2006
Last updated
06/18/2008
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