Michigan Cosmetic & Reconstructive Surgery PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

MICHIGAN COSMETIC & RECONSTRUCTIVE SURGERY PLLC

Practice address

29110 Inkster Rd
Ste 250
Southfield, MI 48034-1098

Phone

(248) 948-5500

Fax

(248) 948-8085

NPI assigned

Apr 30, 2008

Organization subpart

No

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

Authorized official

Name

Mariam Awada, MD

Title

President

Phone

(248) 948-5500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1902072952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673053",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482673053",
            "telephone_number": "248-948-5500",
            "fax_number": "248-948-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29110 INKSTER RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341098",
            "telephone_number": "248-948-5500",
            "fax_number": "248-948-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN COSMETIC & RECONSTRUCTIVE SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "AWADA",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-948-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Plastic and Reconstructive Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.