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General NPI Number Information
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NPI Number | 1225020944
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Entity Type | Organization
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Legal Business Name | NORTH STAR PATHOLOGY PLLC
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 618 S MAIN ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5020
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Country | US
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Telephone | 336-951-4551
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Fax | 336-951-4909
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Provider Business Mailing Address
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Address Line | PO BOX 3391
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City | MARTINSVILLE
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State | VA
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Zip | 24115-3391
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Country | US
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Telephone | 276-670-2400
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Fax | 276-670-2406
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HUGH E FRASER III
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Credential | MD
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Telephone | 336-951-4551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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