Healthcare Provider Details

I. General information

NPI: 1679658751
Provider Name (Legal Business Name): FREDERICK PATHOLOGY CONSULTANTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WEST SEVENTH STREET
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

P.O. BOX 43130
BALTIMORE MD
21236-5915
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3300
  • Fax: 240-566-7410
Mailing address:
  • Phone: 410-931-0400
  • Fax: 410-931-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHISH BARMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-360-2527