Glow Plastic Surgery, PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

200400591 Issued in NC

Legal business name

GLOW PLASTIC SURGERY, PC

Practice address

10010 Falls of Neuse Rd
Suite 102
Raleigh, NC 27614-8494

Phone

(919) 673-4502

Fax

(919) 848-4603

NPI assigned

Jan 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lonnie Bunn

Title

Cfo

Phone

(919) 673-4502

Specialties & licenses 1

Addresses

Other names 1

• Plastix MD PC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1831587435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494",
            "telephone_number": "919-673-4502",
            "fax_number": "919-848-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "address_2": "SUITE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494",
            "telephone_number": "919-673-4502",
            "fax_number": "919-848-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "BUNN",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-673-4502"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200400591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plastix MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mikaela Glover
• Penny Glover, RBT
• Yolonda M Glover
• Glow Care Support, PLLC
• Glow Mind Care PLLC
• Kathryn Leigh Gloyer, M.D.
• Bethany P. Glueck, PH.D, LCMHC-S
• Laurea Caroline Glusman McAllister, MSW, MDIV, LCSW
• Brianna Glynn-Servedio, PHARM.D.
• Martus Zheng Quan GN

• Plastic Surgery Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.