Organization
INVMD PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN NICOLAS VIAL M.D. (SOLE MEMBER)
(541) 317-0808
Entity
Organization
Contact information
Practice address
2450 NE MARY ROSE PL, STE 200, BEND, OR 97701-7132
(541) 317-0808
(541) 317-3585
Mailing address
2450 NE MARY ROSE PL, STE 201, BEND, OR 97701
(541) 317-0808
(541) 317-3585
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719361
—
OR
Enumeration date
12/21/2016
Last updated
06/11/2019
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