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General NPI Number Information
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NPI Number | 1285973909
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Entity Type | Organization
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Legal Business Name | COUNTY SURGICAL PATHOLOGY
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 14222 REELFOOT LAKE DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2936
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Country | US
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Telephone | 314-283-3393
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Fax | 888-977-8863
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Provider Business Mailing Address
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Address Line | 14222 REELFOOT LAKE DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2936
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Country | US
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Telephone | 314-283-3393
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Fax | 888-977-8863
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Authorized Official
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Title or Position | MANAGER
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Name | MR. SYED T HAIDER
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Credential |
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Telephone | 314-283-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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