Healthcare Provider Details
I. General information
NPI: 1548598626
Provider Name (Legal Business Name): PATHOLOGY CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2009
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US
IV. Provider business mailing address
8166 MARKET ST SUITE D
YOUNGSTOWN OH
44512-6262
US
V. Phone/Fax
- Phone: 330-953-3242
- Fax:
- Phone: 330-953-3242
- Fax: 330-953-3243
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KEVIN
SHEETZ
Title or Position: MANAGER
Credential: M.D.
Phone: 330-953-3242