Seasons Plastic & Reconstructive Surgery
LBN: Michael R Dibenedetto Md Pllc
Seasons Plastic & Reconstructive Surgery is an health care organization with primary practice located at 30544 Highway 200 Suite 102, Ponderay ID 83852-5005. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as the primary health care specialty.
Michael R Dibenedetto Md Pllc can be contacted via phone (208) 263-5900, or through Brosnahan, Wendy S via phone (208) 263-5900.
Contact Information
Primary practice address
30544 Highway 200 Suite 102
Ponderay ID 83852-5005
Phone: (208) 263-5900
Fax: (208) 263-1319
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | M10671 | Idaho |
Profile Details
| NPI number | 1073757464 |
|---|---|
| LBN Legal business name | Michael R Dibenedetto Md Pllc |
| DBA Doing business as | Seasons Plastic & Reconstructive Surgery |
| Authorized official | Brosnahan, Wendy S |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Apr 29th, 2009 |
| Last updated | Oct 21st, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073757464 | NPPES |
| Idaho | Other | DG3627 | RAIL ROAD MEDICARE |
| Idaho | Other | 8N834 | RAIL ROAD MEDICARE |
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