Provider Demographics
NPI:1629276282
Name:CENTER FOR AESTHETIC PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:CENTER FOR AESTHETIC PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:9197-349-0909
Mailing Address - Street 1:2307 NORWOOD AVE STE H
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1601
Mailing Address - Country:US
Mailing Address - Phone:919-734-9090
Mailing Address - Fax:919-734-2909
Practice Address - Street 1:2307 NORWOOD AVE STE H
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1601
Practice Address - Country:US
Practice Address - Phone:919-734-9090
Practice Address - Fax:919-734-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42414OtherBCBS
NC8942414Medicaid
NC8942414Medicaid
NC2332183Medicare ID - Type Unspecified