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NPI Code Detail

MEDICARE: CONTEMPORARY COSMETIC SURGERY, INC.

MEDICARE: CONTEMPORARY COSMETIC SURGERY, INC.
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
12086S0122XPlastic and Reconstructive Surgery Physician

General Provider Information

NPI Number : 1780755827
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONTEMPORARY COSMETIC SURGERY, INC.
Provider Business Mailing Address
First Line : PO BOX 22958
Second Line :
City : CLEVELAND
State : OH
Zip : 44122-0958
Country : US
Telephone Number : 216-595-9600
Fax Number :
Provider Business Practice Location Address
First Line : 3733 PARK EAST DR
Second Line : SUITE 107
City : BEACHWOOD
State : OH
Zip : 44122-4338
Country : US
Telephone Number : 216-595-6800
Fax Number : 216-593-0414
Authorized Official
Title or Position : PRESIDENT
Name : BRYAN J MICHELOW
Credential : M.D.
Telephone Number : 216-595-6800
Provider Enumeration Date : 11/12/2006
Last Update Date : 08/22/2020

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Directions to “CONTEMPORARY COSMETIC SURGERY, INC. ” Practice Location

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