Organization
PEACHTREE PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE Y MA MD (CEO, OWNER)
(404) 841-8450
Entity
Organization
Contact information
Practice address
3286 NORTHSIDE PKWY NW STE 1000, ATLANTA, GA 30327-2294
(404) 841-8450
(404) 841-8453
Mailing address
3286 NORTHSIDE PKWY NW STE 1000, ATLANTA, GA 30327-2294
(404) 841-8450
(404) 841-8453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
047345
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947383A
—
GA
Enumeration date
08/31/2006
Last updated
06/30/2022
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