Renaissance Plastic Surgery PC
Organization Active NPI Plastic Surgery Physician · Indpls, IN
NPI 1407914567 · NPPES record last updated Jun 27, 2013
Key facts
- NPI
- 1407914567
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Plastic Surgery Physician 208200000X
- Legal business name
- RENAISSANCE PLASTIC SURGERY PC
- Practice address
- 10293 N Meridian St
Suite 200
Indpls, IN 46290 - Phone
- (317) 575-9152
- Fax
- (317) 575-9281
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Joseph J Fata
- Title
- Owner
- Phone
- (317) 575-9152
National Provider Directory
Locations
10293 N Meridian St
Ste 200
Carmel, IN 46290
Phone (317) 575-9152
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician |
208200000X | Yes |
Addresses
Primary practice location
10293 N Meridian St
Suite 200
Indpls, IN 46290
Mailing address
10293 N Meridian St
Suite 200
Indpls, IN 46290
Phone (317) 575-9152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100120400A | Medicaid | IN |
Other providers in Indpls, IN
- Maureen Anne Moriarty
- Andrew Morrison
- Northside OB/GYN Inc
- Karen Ellen Patrick
- Carl Dixon Quedenfeld
- Renew Hearing, Inc
- Barbara Gail Siegel
- Savannah Taylor-Adkins
- Jason William Todd
- W Michael Princell DDS PC
All providers in Indpls, IN · Plastic Surgery Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.