Birmingham Cosmetic Surgery LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301047649 Issued in MI

Legal business name

BIRMINGHAM COSMETIC SURGERY LLC

Practice address

30603 Southfield Rd
Southfield, MI 48076-7729

Phone

(248) 723-9370

Fax

(248) 723-9687

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Rafai Rouchdi, MD

Title

Owner

Phone

(248) 723-9370

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1952431744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30603 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480767729",
            "telephone_number": "248-723-9370",
            "fax_number": "248-723-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30603 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480767729",
            "telephone_number": "248-723-9370",
            "fax_number": "248-723-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRMINGHAM COSMETIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ROUCHDI",
        "authorized_official_first_name": "RAFAI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-723-9370",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301047649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301047649",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.