Provider Demographics
NPI:1396755534
Name:RESTORATION PLASTIC SURGERY, PC
Entity type:Organization
Organization Name:RESTORATION PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:FREMLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-466-3261
Mailing Address - Street 1:12207 PECOS ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3892
Mailing Address - Country:US
Mailing Address - Phone:303-466-3261
Mailing Address - Fax:303-466-3674
Practice Address - Street 1:12207 PECOS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3892
Practice Address - Country:US
Practice Address - Phone:303-466-3261
Practice Address - Fax:303-466-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33252343Medicaid
COG57601Medicare UPIN
CO33252343Medicaid