MEDICARE: HORIZON SURGICAL GROUP, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician		MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366449365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON SURGICAL GROUP, PA

Provider Business Mailing Address
First Line	:	20410 OBSERVATION DRIVE
Second Line	:	SUITE 100
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-6419
Country	:	US
Telephone Number	:	301-762-0277
Fax Number	:	301-330-9108

Provider Business Practice Location Address
First Line	:	20410 OBSERVATION DRIVE
Second Line	:	SUITE 100
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-6419
Country	:	US
Telephone Number	:	301-762-0277
Fax Number	:	301-330-9108

Authorized Official
Title or Position	:	PARTNER/AUTHORIZED OFFICIAL
Name	:	MR. ROBERT FOX
Credential	:	M.D.
Telephone Number	:	301-330-1000

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	03/22/2017

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