Healthcare Provider Details

I. General information

NPI: 1770555831
Provider Name (Legal Business Name): ASSOCIATED PATHOLOGISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 BLACK RIVER RD
GEORGETOWN SC
29440-3304
US

IV. Provider business mailing address

PO BOX 30309
CHARLESTON SC
29417-0309
US

V. Phone/Fax

Practice location:
  • Phone: 843-527-7171
  • Fax: 843-520-7882
Mailing address:
  • Phone: 843-554-9300
  • Fax: 843-566-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. STEVEN BRUCE VALLERY
Title or Position: PRESIDENT
Credential: MD
Phone: 843-527-7171