Healthcare Provider Details

I. General information

NPI: 1518944107
Provider Name (Legal Business Name): CAROLINA PATHOLOGY ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 SPRING ST
GREENWOOD SC
29646-3860
US

IV. Provider business mailing address

PO BOX 602399
CHARLOTTE NC
28260-2399
US

V. Phone/Fax

Practice location:
  • Phone: 864-725-4822
  • Fax: 864-725-4679
Mailing address:
  • Phone: 804-350-2889
  • Fax: 804-545-0652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DARRYL LYNN MCLEOD
Title or Position: PARTNER
Credential: MD FACP FACPE
Phone: 864-725-4822