| Organization Name: | PRINCE WILLIAM PLASTIC SURGERY AND SPA SERVICES COMPANY, LLC |
| NPI Number: | 1952611147 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL PHILLIP GROSS (CLINICAL DIRECTOR) |
| Mailing Address: | 1940 Opitz Boulevard Woodbridge |
| State: | VA US |
| Postal Code: | 22191 |
| Phone Number: | 7034941163 |
| Fax Number: | 7034942181 |
| NPI Enumeration Date: | 10/21/2010 |
| NPI Last Update Date: | 10/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Plastic Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |