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PREMIERE CENTER FOR COSMETIC SURGERY NPI 1811185481


NPI Information

NPI: 1811185481
Provider Name: PREMIERE CENTER FOR COSMETIC SURGERY
Classification: Plastic Surgery - 208200000X
Entity Type: Organization

CLIA Number: 10D2071769

Address:
3930 PENDER DR
SUITE 120
FAIRFAX, VA
ZIP 22030
Phone: (703) 752-6608
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PREMIERE CENTER FOR COSMETIC SURGERY is a plastic surgery in Fairfax, 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. PREMIERE CENTER FOR COSMETIC SURGERY NPI is 1811185481. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3930 PENDER DR
SUITE 120
FAIRFAX, VA
ZIP 22030-985
Phone: (703) 752-6608

The provider's authorized official is Cynthia Trautman .
The authorized official title is Practice Manager and has the following contact phone number (813) 305-9100.

The CLIA number assigned to this NPI record is 10D2071769 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 7/31/2023.


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
1208200000XPlastic SurgeryYes

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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