Healthcare Provider Details

I. General information

NPI: 1366679466
Provider Name (Legal Business Name): AMERIPATH 501A CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 BUTLER STREET SUITE 115
DALLAS TX
75235-7800
US

IV. Provider business mailing address

7111 FAIRWAY DRIVE SUITE 400
PALM BEACH GARDENS FL
33418-4207
US

V. Phone/Fax

Practice location:
  • Phone: 800-309-0000
  • Fax: 214-630-5210
Mailing address:
  • Phone: 561-712-6200
  • Fax: 561-712-7349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD M KRAMER
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 610-550-3000