Provider Demographics
NPI:1386631711
Name:CENTER FOR PLASTIC SURGERY, PC
Entity type:Organization
Organization Name:CENTER FOR PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:FLEURY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:301-652-7700
Mailing Address - Street 1:5550 FRIENDSHIP BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7256
Mailing Address - Country:US
Mailing Address - Phone:301-652-7700
Mailing Address - Fax:301-907-6590
Practice Address - Street 1:5550 FRIENDSHIP BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7256
Practice Address - Country:US
Practice Address - Phone:301-652-7700
Practice Address - Fax:301-907-6590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
072612Medicare ID - Type UnspecifiedGROUP ANUMBER