Healthcare Provider Details

I. General information

NPI: 1558857706
Provider Name (Legal Business Name): PLASTIC SURGERY ASSOCIATES OF RICHMOND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11934 W BROAD ST STE 200
RICHMOND VA
23233-1100
US

IV. Provider business mailing address

11934 W BROAD ST STE 200
RICHMOND VA
23233-1100
US

V. Phone/Fax

Practice location:
  • Phone: 804-423-2100
  • Fax: 804-716-5057
Mailing address:
  • Phone: 804-423-2100
  • Fax:

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: NEIL ZEMMEL
Title or Position: CEO
Credential: MD
Phone: 804-423-2100