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General NPI Number Information
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NPI Number | 1952581613
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Entity Type | Organization
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Legal Business Name | RETSON PLASTIC SURGERYPC
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Dates
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Enumeration Date | 11/11/2007
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 8053 CLEVELAND PL
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5303
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Country | US
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Telephone | 219-769-4456
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Fax | 219-769-1468
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Provider Business Mailing Address
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Address Line | 8053 CLEVELAND PL
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5303
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Country | US
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Telephone | 219-769-4456
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Fax | 219-769-1468
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MR. NICHOLAS C RETSON
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Credential | M.D.
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Telephone | 219-769-4456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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