Provider Demographics
NPI:1073979373
Name:SERAFIN PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:SERAFIN PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SERAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-220-7711
Mailing Address - Street 1:824 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1054
Mailing Address - Country:US
Mailing Address - Phone:919-220-7711
Mailing Address - Fax:919-220-7722
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:SUITE 104 B
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:919-220-7711
Practice Address - Fax:919-220-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14298208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC86389Medicare UPIN
NC4305Medicare PIN