FAYETTEVILLE PLASTIC SURGERY SPECIALISTS, PA
NPI 1093808388
Plastic Surgery in Fayetteville, NC

Q: What is Fayetteville Plastic Surgery Specialists, PA's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Active since October 01, 2006CLIA 34D2228935 · Waiver

1774 METROMEDICAL DR, FAYETTEVILLE, NC 28304(910) 323-1203(910) 483-1130 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fayetteville Plastic Surgery Specialists, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTEVILLE PLASTIC SURGERY SPECIALISTS, PA (NPI 1093808388) is a healthcare organization registered as a plastic surgery in Fayetteville, North Carolina and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through July 1, 2027 and lists Horace William Miller, President, as its authorized official.

NPPES Registry Identity

NPI1093808388

Entity TypeOrganization

Primary Taxonomy208200000X

Legal Business NameFAYETTEVILLE PLASTIC SURGERY SPECIALISTS, PA

Location Address1774 METROMEDICAL DRFayetteville, NC 28304-3861

Mailing Address1774 Metromedical DrFayetteville, NC 28304-3861 · (910) 323-1203 · Fax (910) 483-1130

Phone(910) 323-1203

Fax(910) 483-1130

Organization SubpartNo

Authorized OfficialHorace William MillerPresident · (910) 323-1203

Enumeration DateOctober 1, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1093808388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in NC · 27390

Definition

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.

1774 METROMEDICAL DR, Fayetteville, NC 28304

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Other Identifiers 1

Medicaid8959118NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2228935

Fayetteville Plastic Surgery · Fayetteville, NC

Active · expires Jul 1, 2027

CLIA Number34D2228935

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJuly 2, 2025

Certificate Expiration DateJuly 1, 2027

Laboratory DirectorEdward Dickerson

Laboratory Phone(910) 323-3757

Laboratory LocationFayetteville Plastic Surgery2053 Valley Gate Drive Suite 102, Fayetteville, NC 28304

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HORACE WILLIAM MILLER IV MD

Plastic Surgery