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SOUTHWEST VIRGINIA CENTER FOR COSMETIC PLASTIC & RECON SURGERY NPI 1609958776


NPI Information

NPI: 1609958776
Provider Name: SOUTHWEST VIRGINIA CENTER FOR COSMETIC PLASTIC & RECON SURGERY
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
2965 COLONNADE DRIVE
SUITE 140
ROANOKE, VA
ZIP 24018
Phone: (540) 989-6361
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SOUTHWEST VIRGINIA CENTER FOR COSMETIC PLASTIC & RECON SURGERY is a plastic surgery in Roanoke, VA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. SOUTHWEST VIRGINIA CENTER FOR COSMETIC PLASTIC & RECON SURGERY NPI is 1609958776. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2965 COLONNADE DRIVE
SUITE 140
ROANOKE, VA
ZIP 24018-541
Phone: (540) 989-6361
Fax: (540) 989-6361

The provider's authorized official is Michael J Breiner .
The authorized official title is President and has the following contact phone number (540) 989-6361.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 4/11/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist0101050226VIRGINIANo
2208200000XPlastic Surgery0101050226VIRGINIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1348227OTHERMAMSI
2C06519MEDICARE PIN
306901051MEDICAIDVIRGINIA
4240000224MEDICARE OSCAR/CERTIFICATION
5323954OTHERANTHEM
6089951000OTHERQUAL CHOICE
7240000224OTHERUNITED HEALTHCARE
8F65641MEDICARE UPIN
9AETNAOTHER4420846
1076991OTHERSOUTHERN HEALTH

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

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