Provider Demographics
NPI:1598067464
Name:AMERICAN SURGICAL ARTS, PC
Entity Type:Organization
Organization Name:AMERICAN SURGICAL ARTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIDIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-362-8898
Mailing Address - Street 1:199 MULLICA HILL RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2655
Mailing Address - Country:US
Mailing Address - Phone:856-362-8898
Mailing Address - Fax:856-362-8903
Practice Address - Street 1:199 MULLICA HILL RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2655
Practice Address - Country:US
Practice Address - Phone:856-362-8898
Practice Address - Fax:856-362-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08686600208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730124256OtherNPI OF OWNER