MEDICARE: RECONSTRUCTIVE SURGICAL GROUP LLC

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
1	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1588506422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECONSTRUCTIVE SURGICAL GROUP LLC

Provider Business Mailing Address
First Line	:	2829 SHORE DR STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1498
Country	:	US
Telephone Number	:	757-734-1000
Fax Number	:	757-734-1001

Provider Business Practice Location Address
First Line	:	2829 SHORE DR STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1498
Country	:	US
Telephone Number	:	757-734-1000
Fax Number	:	757-734-1001

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. MICHELLE LAMPRECHT
Credential	:
Telephone Number	:	757-734-1000

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “RECONSTRUCTIVE SURGICAL GROUP LLC ” Practice Location

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