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EXECUTIVE PLASTIC SURGERY, PLLC
NPI 1649675174
Plastic Surgery in Bloomfield Hills, MI

Active since October 27, 2014
43940 WOODWARD AVE STE 100, BLOOMFIELD HILLS, MI 48302(734) 419-1615(248) 934-2185 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 29, 2018, Oct 22, 2018 (2 updates tracked since 2018).

About Executive Plastic Surgery, Pllc NPPES

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

EXECUTIVE PLASTIC SURGERY, PLLC (NPI 1649675174), doing business as Crescent Plastic Surgery, Pllc, is a healthcare organization registered as a plastic surgery in Bloomfield Hills, Michigan and active in the NPI registry since October 2014. The organization lists Shaher W Khan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1649675174
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameEXECUTIVE PLASTIC SURGERY, PLLC
Location Address43940 WOODWARD AVE STE 100Bloomfield Hills, MI 48302-5025
Mailing Address43940 Woodward Ave Ste 100Bloomfield Hills, MI 48302-5025 · (734) 419-1615 · Fax (248) 934-2185
Phone(734) 419-1615
Fax(248) 934-2185
Organization SubpartNo
Authorized OfficialShaher W KhanCeo · (734) 419-1615
Enumeration DateOctober 27, 2014
Last NPPES UpdateMarch 22, 20242 updates tracked since enumeration
NPPES CertifiedMarch 22, 2024
✔ NPI 1649675174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in MI · 4301098160
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.
43940 WOODWARD AVE STE 100, Bloomfield Hills, MI 48302
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Other Names 1

Former Legal Business NameCrescent Plastic Surgery, Pllc

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

Other Providers at the Same Location NPPES

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

DR. SHAHER W KHAN MD
Plastic Surgery
43940 WOODWARD AVE STE 100
BLOOMFIELD HILLS, MI 48302
Oakland County (734) 419-1615

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Executive Plastic Surgery, PLLC's NPI number?

The NPI number for Executive Plastic Surgery, PLLC is 1649675174. It was assigned to this organization in the NPPES registry on October 27, 2014. The provider was formerly known as Crescent Plastic Surgery, PLLC.

Where is Executive Plastic Surgery, PLLC located?

Executive Plastic Surgery, PLLC is located at 43940 Woodward Ave Ste 100, Bloomfield Hills, MI 48302. The listed phone number is (734) 419-1615.

What is Executive Plastic Surgery, PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Executive Plastic Surgery, PLLC was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.