Provider Demographics
NPI:1891199923
Name:HINJEW1
Entity Type:Organization
Organization Name:HINJEW1
Other - Org Name:PACES PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:KAILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-842-1000
Mailing Address - Street 1:365 E PACES FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2351
Mailing Address - Country:US
Mailing Address - Phone:404-842-1000
Mailing Address - Fax:
Practice Address - Street 1:365 E PACES FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2351
Practice Address - Country:US
Practice Address - Phone:404-842-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty