Provider Demographics
NPI:1083779888
Name:XYDAS, STEVE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:XYDAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVE
Mailing Address - Street 2:MID-ATLANTIC SURGICAL ASSOCIATES
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-971-7300
Mailing Address - Fax:973-984-7019
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:GAGNON LEVEL C MID-ATLANTIC SURGICAL ASSOCIATES
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-971-7300
Practice Address - Fax:973-984-7019
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY226941208G00000X
NJ226941208G00000X
NJ85359208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14853IB9MMedicare Oscar/Certification