Healthcare Provider Details

I. General information

NPI: 1245239805
Provider Name (Legal Business Name): DIAGNOSTIC PATHOLOGY CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2005
Last Update Date: 04/12/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DRIVE PATHOLOGY DEPT
VOORHEES NJ
08043-0804
US

IV. Provider business mailing address

100 BOWMAN DRIVE PATHOLOGY DEPT
VOORHEES NJ
08043-0100
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-3174
  • Fax:
Mailing address:
  • Phone: 856-274-3174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DAVID OBANDO
Title or Position: HEAD PATHOLOGIST
Credential: M.D.
Phone: 865-325-3184