Healthcare Provider Details

I. General information

NPI: 1730240995
Provider Name (Legal Business Name): MEASE PATHOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MAIN ST MS417
DUNEDIN FL
34698-5848
US

IV. Provider business mailing address

PO BOX 198317
ATLANTA GA
30384-8317
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-6635
  • Fax:
Mailing address:
  • Phone: 727-734-6635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER D WILLIAMS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-734-6635