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General NPI Number Information
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NPI Number | 1538004171
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Entity Type | Organization
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Legal Business Name | MOSTOVYCH FACIAL PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 2220 NW LABICHE LN STE 130
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City | BEND
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State | OR
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Zip | 97703-6748
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Country | US
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Telephone | 541-728-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 NW LABICHE LN STE 130
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City | BEND
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State | OR
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Zip | 97703-6748
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Country | US
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Telephone | 541-728-2026
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. NADIA MOSTOVYCH
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Credential | MD
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Telephone | 240-751-3172
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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 |
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License Number State |
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