Provider Demographics
NPI:1225545320
Name:YONICK PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:YONICK PLASTIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YONICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-495-2723
Mailing Address - Street 1:555 W WACKERLY ST STE 3625
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4715
Mailing Address - Country:US
Mailing Address - Phone:989-495-2723
Mailing Address - Fax:989-495-2724
Practice Address - Street 1:555 W WACKERLY ST STE 3625
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4715
Practice Address - Country:US
Practice Address - Phone:989-495-2723
Practice Address - Fax:989-495-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty