Provider Demographics
NPI:1659348696
Name:BURNS, PAUL G (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:G
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVENUE
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 1:200 TRENTON RD (DEBORAH HEART & LUNG CENTER) -
Practice Address - Street 2:MID-ATLANTIC SURGICAL ASSOCIATES
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015
Practice Address - Country:US
Practice Address - Phone:973-971-7300
Practice Address - Fax:973-984-7019
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07298800207RC0000X
NJMA072988208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8623104Medicaid
NJ8623104Medicaid
NJ051644PEVMedicare ID - Type Unspecified