Organization
SOUTH SHORE PLASTIC SURGERY
Active
Other names
Boston Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
FOUAD J SAMAHA M.D. (PRESIDENT)
(617) 786-7600
Entity
Organization
Contact information
Practice address
2300 CROWN COLONY DR, SUITE 101, QUINCY, MA 02169-0902
(617) 786-7600
(617) 786-7616
Mailing address
2300 CROWN COLONY DR, SUITE 101, QUINCY, MA 02169-0902
(617) 786-7600
(617) 786-7616
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043212541
BLUE CROSS BLUE SHIELD
MA
01
—
21222
HPHC
MA
Enumeration date
06/05/2009
Last updated
08/25/2009
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