Organization
HIGH POINT PLASTIC SURGERY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAVIJ DAVID BURAPAVONG M.D. (PRESIDENT)
(336) 882-2531
Entity
Organization
Contact information
Practice address
416 GATEWOOD AVE, HIGH POINT, NC 27262-4718
(336) 882-2531
(336) 884-8254
Mailing address
416 GATEWOOD AVE, HIGH POINT, NC 27262-4718
(336) 882-2531
(336) 884-8254
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19212
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01794
BLUE CROSS BLUE SHIELD
NC
05
—
7901794
—
NC
Enumeration date
06/19/2006
Last updated
06/30/2011
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