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General NPI Number Information
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NPI Number | 1427479831
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Entity Type | Organization
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Legal Business Name | HARMYCH FACIAL PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | 29225 CHAGRIN BLVD SUITE 285
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City | BEACHWOOD
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State | OH
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Zip | 44122-4645
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Country | US
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Telephone | 216-831-3223
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Fax | 216-831-3224
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Provider Business Mailing Address
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Address Line | 29225 CHAGRIN BLVD SUITE 285
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City | BEACHWOOD
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State | OH
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Zip | 44122-4645
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Country | US
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Telephone | 216-831-3223
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Fax | 216-831-3224
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. BRIAN HARMYCH
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Credential | M.D.
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Telephone | 513-520-0114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 35.098399
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License Number State | OH
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