Provider Demographics
NPI:1265684286
Name:CARP COSMETIC SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:CARP COSMETIC SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-899-1500
Mailing Address - Street 1:4031 MASSILLON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7869
Mailing Address - Country:US
Mailing Address - Phone:330-899-1500
Mailing Address - Fax:330-899-1509
Practice Address - Street 1:4031 MASSILLON RD
Practice Address - Street 2:SUITE A
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7869
Practice Address - Country:US
Practice Address - Phone:330-899-1500
Practice Address - Fax:330-899-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH35073804208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG16584Medicare UPIN