Provider Demographics
NPI:1962677989
Name:PLASTIC SURGERY SPECIALISTS, PC
Entity type:Organization
Organization Name:PLASTIC SURGERY SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-841-5355
Mailing Address - Street 1:2448 HOLLY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3148
Mailing Address - Country:US
Mailing Address - Phone:410-841-5355
Mailing Address - Fax:410-841-6589
Practice Address - Street 1:2448 HOLLY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3148
Practice Address - Country:US
Practice Address - Phone:410-841-5355
Practice Address - Fax:410-841-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS614Medicare PIN