Organization
AESTHETIC & RECONSTRUCTIVE PLASTIC SURGERY,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARYANN M DAVIS (PRACTICE MANAGER)
(919) 785-1220
Entity
Organization
Contact information
Practice address
2304 WESVILL CT, # 360, RALEIGH, NC 27607-2973
(919) 785-1220
(919) 785-1205
Mailing address
2304 WESVILL CT, # 360, RALEIGH, NC 27607-2973
(919) 785-1220
(919) 785-1205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31126
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8927438
—
NC
Enumeration date
05/18/2006
Last updated
10/20/2010
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