MEDICARE: PATHQUEST M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician		OH

General Provider Information

NPI Number	:	1053305375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHQUEST M.D., INC.

Provider Business Mailing Address
First Line	:	P O BOX 634790
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:	216-464-5160
Fax Number	:	216-464-5982

Provider Business Practice Location Address
First Line	:	27100 CHARDON RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1116
Country	:	US
Telephone Number	:	440-585-6417
Fax Number	:	440-585-6418

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PRABHA MURTHY
Credential	:	M.D.
Telephone Number	:	440-585-6417

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	07/21/2022

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