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NPI Code Detail

MEDICARE: PLASTIC SURGICAL CENTER

MEDICARE: PLASTIC SURGICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208200000XPlastic Surgery Physician24782IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285722264
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLASTIC SURGICAL CENTER
Provider Business Mailing Address
First Line : 3705 RIVER RIDGE DR NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-7596
Country : US
Telephone Number : 319-393-1902
Fax Number : 319-393-1867
Provider Business Practice Location Address
First Line : 3705 RIVER RIDGE DR NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-7596
Country : US
Telephone Number : 319-393-1902
Fax Number : 319-393-1867
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : DR. CHARLES E GRADO
Credential : M.D.
Telephone Number : 319-393-1902
Provider Enumeration Date : 10/11/2006
Last Update Date : 06/18/2008

Similar Medicare Providers

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Practice Location Address:
3705 RIVER RIDGE DR NE
CEDAR RAPIDS, IA
52402-7596
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Practice Fax:
1710988217 — DR. CHARLES EVERETT GRADO M.D.
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3705 RIVER RIDGE DR NE
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1093778532 — ALAN WHITTERS MD
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1124071089 — CEDAR RAPIDS PSYCHIATRY
Practice Location Address:
3705 RIVER RIDGE DR NE
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52402-7596
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1861538142 — MONA MCCALLEY-WHITTERS PHD
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1497048805 — TAKINTOPE AKINBIYI M.D.
Practice Location Address:
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Directions to “PLASTIC SURGICAL CENTER ” Practice Location

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