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General NPI Number Information
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NPI Number | 1851385892
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Entity Type | Organization
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Legal Business Name | PATHOLOGY SERVICES OF SOUTHWEST VIRGINIA PC
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3700 S MAIN ST
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City | BLACKSBURG
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State | VA
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Zip | 24060-7017
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Country | US
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Telephone | 540-953-5465
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Fax | 540-953-5274
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Provider Business Mailing Address
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Address Line | PO BOX 10776
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City | BLACKSBURG
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State | VA
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Zip | 24062-0776
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Country | US
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Telephone | 540-767-2700
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Fax | 540-767-2708
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIGUEL LANGEBECK
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Credential | MD
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Telephone | 540-953-5465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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