Provider Demographics
NPI:1710454368
Name:SURFIELD PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:SURFIELD PLASTIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SURFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-621-1940
Mailing Address - Street 1:701 TYLER ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3321
Mailing Address - Country:US
Mailing Address - Phone:419-621-1940
Mailing Address - Fax:419-621-5530
Practice Address - Street 1:701 TYLER ST STE 301
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3321
Practice Address - Country:US
Practice Address - Phone:419-621-1940
Practice Address - Fax:419-621-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty