| Organization Name: | PLASTIC SURGERY, NERVE & HEADACHE INSTITUTE LLC. |
| NPI Number: | 1275959371 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IVICA DUCIC (MEDICAL DOCTOR, PH.D) |
| Mailing Address: | 7601 Lewinsville Rd Suite 460 Mc Lean |
| State: | VA US |
| Postal Code: | 221022814 |
| Phone Number: | 7039929233 |
| Fax Number: | |
| NPI Enumeration Date: | 03/13/2014 |
| NPI Last Update Date: | 08/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MD31470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |