Provider Demographics
NPI:1831302058
Name:CARDIOTHORACIC AND VASCULAR SURGERY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIOTHORACIC AND VASCULAR SURGERY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:EGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-829-5603
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 211 SOUTH
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2993
Mailing Address - Country:US
Mailing Address - Phone:202-829-5603
Mailing Address - Fax:202-829-2317
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 211 SOUTH
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2993
Practice Address - Country:US
Practice Address - Phone:202-829-5603
Practice Address - Fax:202-829-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD110252086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC011471400Medicaid
DC540470OtherGEHA
DC7468 0002OtherBLUECROSS BLUESHIELD
DC240470OtherUNITED HEALTH CARE
DC011471400Medicaid
DC540470OtherGEHA