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:
Map and Directions
Authorized official contact:
Name: Brosnahan, Wendy S
Phone: (208) 263-5900

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073757464 NPPES
Idaho Other DG3627 RAIL ROAD MEDICARE
Idaho Other 8N834 RAIL ROAD MEDICARE

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