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General NPI Number Information
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NPI Number | 1154075273
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Entity Type | Organization
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Legal Business Name | PATHOLOGY, INC.
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY NE STE 270
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City | ATLANTA
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State | GA
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Zip | 30328-4290
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Country | US
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Telephone | 404-301-4460
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Fax |
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Provider Business Mailing Address
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Address Line | 5485 BETHELVIEW RD STE 360-366
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City | CUMMING
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State | GA
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Zip | 30040-9735
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Country | US
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Telephone | 404-301-4460
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARMANDO MONCADA
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Credential | MD
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Telephone | 404-301-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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