MEDICARE: CAPITAL AREA SURGICAL ASSOCIATES

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02277400	OTHER	PA	PA BLUE CROSS
2	469587	OTHER	PA	US HEALTHCARE
3	02277400	OTHER	PA	KEYSTONE HEALTH PLAN

General Provider Information

NPI Number	:	1104882299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL AREA SURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	2626 N 3RD ST
Second Line	:	THE ROSE GARDEN, SUITE 2B
City	:	HARRISBURG
State	:	PA
Zip	:	17110-2044
Country	:	US
Telephone Number	:	717-232-4112
Fax Number	:	717-233-8022

Provider Business Practice Location Address
First Line	:	2626 N 3RD ST
Second Line	:	THE ROSE GARDEN, SUITE 2B
City	:	HARRISBURG
State	:	PA
Zip	:	17110-2044
Country	:	US
Telephone Number	:	717-232-4112
Fax Number	:	717-233-8022

Authorized Official
Title or Position	:	PRESIDENT
Name	:	J EDWARD WILSON
Credential	:	M.D.
Telephone Number	:	717-232-4112

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	08/22/2020

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Directions to “CAPITAL AREA SURGICAL ASSOCIATES ” Practice Location

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