EXECUTIVE PLASTIC SURGERY, PLLC – NPI #1649675174
Plastic Surgery

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.

Health Care Provider Taxonomy Code for Plastic Surgery

EXECUTIVE PLASTIC SURGERY, PLLC is a plastic surgeon located in BLOOMFIELD HILLS, MI. NPPES has assigned the NPI number 1649675174 to EXECUTIVE PLASTIC SURGERY, PLLC on October 27, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is CRESCENT PLASTIC SURGERY, PLLC. The primary taxonomy selected by this provider is 208200000X from the Health Care Provider Taxonomy code set, which is classified as Plastic Surgery.

The NPI profile was previously updated about 2 years ago on Mar 22, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EXECUTIVE PLASTIC SURGERY, PLLC below.

NPI Profile for
EXECUTIVE PLASTIC SURGERY, PLLC

NPI Number
1649675174
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EXECUTIVE PLASTIC SURGERY, PLLC
Former Legal Business Name: CRESCENT PLASTIC SURGERY, PLLC
Primary location
43940 WOODWARD AVE STE 100
BLOOMFIELD HILLS, MI 48302-5025
Phone: (734) 419-1615 Fax: (248) 934-2185
1 Other location(s):
1307 Ford Ave
Wyandotte, MI 48192-3823
Phone: (914) 316-8055
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHAHER KHAN
CEO
Phone: (734) 419-1615
Updated
Certification Date
Mar 22, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208200000X
- Plastic Surgery (Primary)		 MI 4301098160

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.