Healthcare Provider Details

I. General information

NPI: 1831302058
Provider Name (Legal Business Name): CARDIOTHORACIC AND VASCULAR SURGERY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW SUITE 211 SOUTH
WASHINGTON DC
20010-2993
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 211 SOUTH
WASHINGTON DC
20010-2993
US

V. Phone/Fax

Practice location:
  • Phone: 202-829-5603
  • Fax: 202-829-2317
Mailing address:
  • Phone: 202-829-5603
  • Fax: 202-829-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD11025
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD11025
License Number StateDC

VIII. Authorized Official

Name: DR. CHRISTOPHER MARK EGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 202-829-5603