Provider Demographics
NPI:1225217128
Name:POINTES PLASTIC SURGERY ASSOCIATES P C
Entity Type:Organization
Organization Name:POINTES PLASTIC SURGERY ASSOCIATES P C
Other - Org Name:GEORGE GOFFAS MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:GOFFAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-773-6900
Mailing Address - Street 1:22631 GREATER MACK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2055
Mailing Address - Country:US
Mailing Address - Phone:586-773-6900
Mailing Address - Fax:586-773-5851
Practice Address - Street 1:22631 GREATER MACK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2055
Practice Address - Country:US
Practice Address - Phone:586-773-6900
Practice Address - Fax:586-773-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGG064416208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M20380Medicare PIN
MIF72991Medicare UPIN