Organization
PRESTIGE PLASTIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ANTHONY VELA M.D. (PRESIDENT)
(410) 290-1696
Entity
Organization
Contact information
Practice address
8600 SNOWDEN RIVER PKWY, SUITE 308, COLUMBIA, MD 21045-1982
(410) 290-1696
Mailing address
8600 SNOWDEN RIVER PKWY, SUITE 308, COLUMBIA, MD 21045-1982
(410) 290-1696
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D0063900
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30PZGA
BLUE CROSS BLUE SHIELD
MD
Enumeration date
12/26/2006
Last updated
04/08/2008
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