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General NPI Number Information
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NPI Number | 1528078813
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Entity Type | Organization
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Legal Business Name | SURGICAL PATHOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 207 GEORGETOWN WRIGHTSTOWN RD
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City | WRIGHTSTOWN
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State | NJ
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Zip | 08562-2520
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Country | US
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Telephone | 609-723-0070
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Fax | 609-723-0073
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Provider Business Mailing Address
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Address Line | 207 GEORGETOWN WRIGHTSTOWN RD
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City | WRIGHTSTOWN
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State | NJ
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Zip | 08562-2520
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Country | US
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Telephone | 609-723-0070
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Fax | 609-723-0073
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL C MCGINNIS
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Credential | MD
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Telephone | 609-723-0070
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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 | 25MA00747300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 25MA00747300
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License Number State | NJ
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