1346314051 NPI number — DAVIS COSMETIC PLASTIC SURGERY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346314051 NPI number — DAVIS COSMETIC PLASTIC SURGERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVIS COSMETIC PLASTIC SURGERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346314051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1916 RT 70 E
Provider Second Line Business Mailing Address:
SUITE ONE
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-424-1700
Provider Business Mailing Address Fax Number:
856-874-0068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1916 RT 70 E
Provider Second Line Business Practice Location Address:
SUITE ONE
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-424-1700
Provider Business Practice Location Address Fax Number:
856-874-0068
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PLASTIC SURGEON
Authorized Official Telephone Number:
856-424-1700

Provider Taxonomy Codes

  • Taxonomy code: 208200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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