Provider Demographics
NPI:1023203791
Name:PLASTIC SURGERY CLINIC P.C.
Entity Type:Organization
Organization Name:PLASTIC SURGERY CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:C
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-277-0500
Mailing Address - Street 1:18181 OAKWOOD BLVD
Mailing Address - Street 2:SUITE NUMBER 202
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-5032
Mailing Address - Country:US
Mailing Address - Phone:313-277-0500
Mailing Address - Fax:313-277-1760
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE NUMBER 202
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5032
Practice Address - Country:US
Practice Address - Phone:313-277-0500
Practice Address - Fax:313-277-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty