Provider Demographics
NPI:1093724700
Name:WASHINGTON REGIONAL CARDIAC SURGERY, PC
Entity Type:Organization
Organization Name:WASHINGTON REGIONAL CARDIAC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-291-1430
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:SUITE 1E3
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2976
Mailing Address - Country:US
Mailing Address - Phone:202-291-1430
Mailing Address - Fax:202-291-1436
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE 1E3
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-291-1430
Practice Address - Fax:202-291-1436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC4934OtherRAILROAD MEDICARE
MDH286OtherBCBS
MD90954110Medicaid
DC021598100Medicaid
DC6176OtherBCBS
MD90954110Medicaid