Organization
GREENSBORO PLASTIC SURGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA KAYE MARTIN (PRACTICE ADMINISTRATOR)
(336) 954-2633
Entity
Organization
Contact information
Practice address
2716 HENRY ST, GREENSBORO, NC 27405-3633
(336) 954-2633
(336) 954-2931
Mailing address
2716 HENRY ST, GREENSBORO, NC 27405-3633
(336) 954-2633
(336) 954-2931
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
26162
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8983872
—
NC
Enumeration date
09/21/2010
Last updated
11/10/2010
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