Aesthetic Center for Plastic Surgery

Organization Active NPI Plastic and Reconstructive Surgery Physician · MC Lean, VA

NPI 1134619166 · NPPES record last updated May 15, 2018

Key facts

NPI
1134619166
Entity type
Organization (NPI type 2)
Primary specialty
Plastic and Reconstructive Surgery Physician 2086S0122X
License
0101039385 (VA)
Legal business name
AESTHETIC CENTER FOR PLASTIC SURGERY
Practice address
6845 Elm St Ste 708
MC Lean, VA 22101-3851
Phone
(703) 893-1111
Fax
(703) 760-9565
NPI assigned
May 15, 2018
Organization subpart
No

Authorized official

Name
Dr. Gloria Duda, M.D.
Title
President
Phone
(703) 893-1111

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2086S0122X 0101039385 VA Yes

Addresses

Primary practice location

6845 Elm St Ste 708
MC Lean, VA 22101-3851

Mailing address

6845 Elm St Ste 708
MC Lean, VA 22101-3851
Phone (703) 893-1111

Other providers in MC Lean, VA

All providers in MC Lean, VA · Plastic and Reconstructive Surgery Physician in Virginia

Sources for this page

Verify at the official NPI Registry.