DEROSA PLASTIC SURGERY PLLC NPI 1144618075

NPI Information

NPI: 1144618075
Provider Name: DEROSA PLASTIC SURGERY, PLLC
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
22401 FOSTER WINTER DR
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 688-7597
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DEROSA PLASTIC SURGERY, PLLC is a plastic and reconstructive surgery surgery in Southfield, MI. The provider is a surgeon who specializes in plastic and reconstructive surgery. DEROSA PLASTIC SURGERY, PLLC NPI is 1144618075. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

22401 FOSTER WINTER DR
SOUTHFIELD, MI
ZIP 48075-724
Phone: (248) 688-7597
Fax: (248) 498-6060

The provider's authorized official is Amy P Derosa .
The authorized official title is Owner and has the following contact phone number (248) 688-7597.

The enumeration date for this NPI number is 12/30/2014 and was last updated on 6/22/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	5101017043	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7789986	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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