Organization
GLOW PLASTIC SURGERY, PC
Active
Other names
Plastix MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE BUNN (CFO)
(919) 673-4502
Entity
Organization
Contact information
Practice address
10010 FALLS OF NEUSE RD, SUITE 102, RALEIGH, NC 27614-8494
(919) 673-4502
(919) 848-4603
Mailing address
10010 FALLS OF NEUSE RD, SUITE 102, RALEIGH, NC 27614-8494
(919) 673-4502
(919) 848-4603
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
200400591
NC
Other
Enumeration date
01/05/2015
Last updated
06/18/2015
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