Provider Demographics
NPI:1003074113
Name:GREATER WASHINGTON PLASTIC SURGERY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GREATER WASHINGTON PLASTIC SURGERY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINEET
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-544-8971
Mailing Address - Street 1:PO BOX 2735
Mailing Address - Street 2:
Mailing Address - City:MERRIFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22116-2735
Mailing Address - Country:US
Mailing Address - Phone:703-544-8971
Mailing Address - Fax:703-562-6994
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:SUITE 330
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-544-8971
Practice Address - Fax:703-562-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-26
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD67453208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty