Provider Demographics
NPI:1134992704
Name:SEACOAST PLASTIC SURGERY AND MEDICAL AESTHETICS, PLLC
Entity type:Organization
Organization Name:SEACOAST PLASTIC SURGERY AND MEDICAL AESTHETICS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:H
Authorized Official - Last Name:SLOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-799-6787
Mailing Address - Street 1:875 GREENLAND RD UNIT C8
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4163
Mailing Address - Country:US
Mailing Address - Phone:603-956-6059
Mailing Address - Fax:603-956-6091
Practice Address - Street 1:875 GREENLAND RD UNIT C8
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4163
Practice Address - Country:US
Practice Address - Phone:603-956-6059
Practice Address - Fax:603-956-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty