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General NPI Number Information
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NPI Number | 1770575433
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Entity Type | Organization
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Legal Business Name | PATHOLOGY ASSOCIATES LABORATORIES, P.C.
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5601 LOCH RAVEN BLVD POB SUITE 201
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City | BALTIMORE
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State | MD
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Zip | 21239-2905
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Country | US
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Telephone | 410-581-1200
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Fax | 410-581-1203
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Provider Business Mailing Address
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Address Line | 23 CROSSROADS DR SUITE 130
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5420
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Country | US
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Telephone | 410-581-1200
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Fax | 410-581-1203
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CAROL J GLUSMAN
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Credential |
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Telephone | 410-581-1200
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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 | 386
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License Number State | MD
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