# UNIVERSITY CARDIAC & THORACIC SURGICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457384661
- **Authorized official:** DANIEL W VANHEECKEREN MD (DEPARTMENT CHAIRMAN)
- **Authorized official phone:** (216) 844-3053

## Contact information

- **Practice address:** 11100 EUCLID AVE, CLEVELAND, OH 44106-1716
- **Practice address phone:** (216) 844-5770
- **Mailing address:** 5910 LANDERBROOK DR, SUITE 250, MAYFIELD HTS, OH 44124-6508
- **Mailing address phone:** (440) 684-5979
- **Mailing address fax:** (440) 449-1555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2054806 | — | OH |
| 01 | — | CN7867 | RAILROAD MEDICARE | OH |