MOUCHANTAT PLASTIC SURGERY PC NPI 1255502753

NPI Information

MOUCHANTAT PLASTIC SURGERY PC is a specialist in Wheat Ridge, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MOUCHANTAT PLASTIC SURGERY PC NPI is 1255502753. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is John M Pav Md Pc.

The provider's business location address is:

3280 WADSWORTH BLVD
SUITE 100
WHEAT RIDGE, CO
ZIP 80033-640
Phone: (303) 232-8585
Fax: (303) 232-3304

The provider's authorized official is Richard A Mouchantat .
The authorized official title is Physician/owner and has the following contact phone number (303) 232-8585.

The enumeration date for this NPI number is 3/12/2008 and was last updated on 9/17/2015.

Taxonomy Codes

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Other Identifiers

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