Provider Demographics
NPI:1538648068
Name:BAYVIEW PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:BAYVIEW PLASTIC SURGERY, PLLC
Other - Org Name:BAYVIEW PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-313-0443
Mailing Address - Street 1:4700 POINT FOSDICK DR NW STE 208
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1775
Mailing Address - Country:US
Mailing Address - Phone:253-313-0443
Mailing Address - Fax:253-509-2328
Practice Address - Street 1:4700 POINT FOSDICK DR NW STE 208
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1775
Practice Address - Country:US
Practice Address - Phone:253-313-0443
Practice Address - Fax:253-509-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60383901208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty