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General NPI Number Information
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NPI Number | 1649459892
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Entity Type | Organization
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Legal Business Name | MARYLAND PATHOLOGY SERVICES
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 182 THOMAS JOHNSON DR SUITE 204
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City | FREDERICK
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State | MD
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Zip | 21702-4407
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Country | US
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Telephone | 301-698-8711
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Fax | 301-698-9122
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Provider Business Mailing Address
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Address Line | 182 THOMAS JOHNSON DR SUITE 204
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City | FREDERICK
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State | MD
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Zip | 21702-4407
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Country | US
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Telephone | 301-698-8711
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Fax | 301-698-9122
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | MRS. HODA FOUAD GABRIEL
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Credential | M.D.
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Telephone | 301-698-8711
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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 | MD
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