Provider Demographics
NPI:1295288751
Name:PLASTIC HEAD AND NECK SURGERY INSTITUTE
Entity type:Organization
Organization Name:PLASTIC HEAD AND NECK SURGERY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADEEP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SINHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-257-1589
Mailing Address - Street 1:5730 GLENRIDGE DR STE T150
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5872
Mailing Address - Country:US
Mailing Address - Phone:404-943-1111
Mailing Address - Fax:404-843-0478
Practice Address - Street 1:5730 GLENRIDGE DR STE T150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5872
Practice Address - Country:US
Practice Address - Phone:404-943-1111
Practice Address - Fax:404-843-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical