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General NPI Number Information
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NPI Number | 1356482517
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Entity Type | Organization
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Legal Business Name | WASHINGTON PATHOLOGY SERVICES., INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 360 MAPLE AVE W SUITE F
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City | VIENNA
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State | VA
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Zip | 22180-5614
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Country | US
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Telephone | 703-255-5504
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Fax | 703-255-5507
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Provider Business Mailing Address
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Address Line | 200 LAWYERS RD, N.W #1455
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City | VIENNA
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State | VA
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Zip | 22183-8071
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Country | US
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Telephone | 703-255-5504
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Fax | 703-255-5507
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDER T OCAMPO
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Credential | M.D
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Telephone | 703-255-5504
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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 | 0101030967
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License Number State | VA
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