NPI 1205486800

Supernova Consulting LLC

Organisation Plastic Surgery Physician Phoenix, AZ

Practice location

Address: 4550 E Bell Rd STE 150, Phoenix, AZ 85032-9382
Phone: (480) 576-4310

Authorised official

Name: Tim Matatov
Title: Ceo
Phone: (480) 576-4310

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X

Other Plastic Surgery providers in Arizona →

Registry record

NPI: 1205486800
Entity type: Organization
NPI issued: 16 Sep 2019
Record last updated: 26 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.