Provider Demographics
NPI:1336349554
Name:CARDIAC SURGERY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CARDIAC SURGERY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORNEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-429-5336
Mailing Address - Street 1:3328 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3855
Mailing Address - Country:US
Mailing Address - Phone:410-429-5336
Mailing Address - Fax:410-429-5336
Practice Address - Street 1:3328 BUTLER RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-3855
Practice Address - Country:US
Practice Address - Phone:410-429-5336
Practice Address - Fax:410-429-5336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2013-09-09
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
MD260551100Medicaid
MDS313Medicare PIN