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General NPI Number Information
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NPI Number | 1689628158
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Entity Type | Organization
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Legal Business Name | CAROLINAS PATHOLOGY GROUP, PA
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1000 BLYTHE BLVD 4TH FLOOR
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City | CHARLOTTE
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State | NC
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Zip | 28203-5812
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Country | US
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Telephone | 704-973-5500
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Fax | 704-973-5518
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Provider Business Mailing Address
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Address Line | PO BOX 96782
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City | CHARLOTTE
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State | NC
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Zip | 28296-6782
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Country | US
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Telephone | 704-973-5500
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Fax | 704-973-5518
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHAD A. LIVASY
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Credential | MD
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Telephone | 704-973-5500
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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 |
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License Number State |
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