BOREALIS PLASTIC SURGERY PLLC NPI 1760777684

NPI Information

BOREALIS PLASTIC SURGERY, PLLC is a plastic and reconstructive surgery surgery in Traverse City, MI. The provider is a surgeon who specializes in plastic and reconstructive surgery. BOREALIS PLASTIC SURGERY, PLLC NPI is 1760777684. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4977 SKYVIEW CT
TRAVERSE CITY, MI
ZIP 49684-941
Phone: (231) 421-6599
Fax: (231) 421-6602

The provider's authorized official is Adam Bryant Smith .
The authorized official title is Physician and has the following contact phone number (231) 421-6599.

The enumeration date for this NPI number is 6/20/2011 and was last updated on 8/3/2011.

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:

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