Healthcare Provider Details

I. General information

NPI: 1578737599
Provider Name (Legal Business Name): RENAISSANCE PLASTIC SURGEONS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 WADSWORTH RD SUITE J
WADSWORTH OH
44281-8330
US

IV. Provider business mailing address

185 WADSWORTH RD SUITE J
WADSWORTH OH
44281-8330
US

V. Phone/Fax

Practice location:
  • Phone: 330-334-7800
  • Fax: 330-334-3252
Mailing address:
  • Phone: 330-334-7800
  • Fax: 330-334-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS H PAPAS
Title or Position: OWNER
Credential: MD
Phone: 330-334-7800