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General NPI Number Information
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NPI Number | 1033150982
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Entity Type | Organization
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Legal Business Name | PATHOLOGY ASSOCIATES OF FREDERICKSBURG PTR
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 1001 SAM PERRY BLVD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4453
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Country | US
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Telephone | 540-741-1168
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Fax | 540-741-1422
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Provider Business Mailing Address
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Address Line | 1001 SAM PERRY BLVD MARY WASHINGTON HOSPITAL
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4453
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Country | US
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Telephone | 540-741-1130
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Fax | 540-741-1142
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | PAUL F HINE
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Credential | MD
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Telephone | 540-741-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State |
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