Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Peninsula Plastic and Reconstructive Surgery of Michigan

Organization Plastic Surgery Physician · NPI 1316774110

Peninsula Plastic and Reconstructive Surgery of Michigan provides Plastic Surgery Physician services in Novi, Michigan. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

47601 Grand River Ave Ste B233
Novi, MI 48374-1204
Phone: (248) 465-5499
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1316774110
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rachel Perry — Cred Coord · (586) 209-8307
NPI enumeratedSeptember 16, 2024
Last updated in NPPESJanuary 21, 2025
Certification dateJanuary 21, 2025
Mailing address47601 Grand River Ave Ste B233, Novi, MI 48374-1204

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