Provider Demographics
NPI:1336863844
Name:AFFILIATES IN PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:AFFILIATES IN PLASTIC SURGERY, LLC
Other - Org Name:SHADY GROVE SURGICENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-888-2034
Mailing Address - Street 1:4660 KENMORE AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1306
Mailing Address - Country:US
Mailing Address - Phone:703-832-4000
Mailing Address - Fax:703-832-4001
Practice Address - Street 1:15245 SHADY GROVE RD STE 155
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6271
Practice Address - Country:US
Practice Address - Phone:301-232-3000
Practice Address - Fax:301-232-3333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFILIATES IN PLASTIC SURGERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-28
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty