Organization
BOREALIS PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM BRYANT SMITH MD (PHYSICIAN)
(231) 421-6599
Entity
Organization
Contact information
Practice address
4977 SKYVIEW CT, TRAVERSE CITY, MI 49684-6941
(231) 421-6599
(231) 421-6602
Mailing address
4977 SKYVIEW CT, TRAVERSE CITY, MI 49684-6941
(231) 421-6599
(231) 421-6602
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
4301084224
MI
Other
Enumeration date
06/20/2011
Last updated
08/03/2011
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