| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Surgery |
| DEFINITION | A surgeon who specializes in plastic and reconstructive surgery. |
| AREA OF SPECIALIZATION | Plastic and Reconstructive Surgery |
| STATUS | Active |
| VA CODE | V183102 |
| X12 CODE | 2086S0122X |
| SPECIALTY CODE | 02 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251406 |
| EFFECTIVE DATE/TIME |
|