Provider Demographics
NPI:1003013681
Name:COMPREHENSIVE SURGICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE SURGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-766-3600
Mailing Address - Street 1:500 POPLAR ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1474
Mailing Address - Country:US
Mailing Address - Phone:304-766-3600
Mailing Address - Fax:
Practice Address - Street 1:500 POPLAR ST
Practice Address - Street 2:SUITE 304
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1474
Practice Address - Country:US
Practice Address - Phone:304-766-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21912208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty