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NPI Code Detail

MEDICARE: CLINICAL PATHOLOGY CONSULTANTS, PA

MEDICARE: CLINICAL PATHOLOGY CONSULTANTS, PA
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265483903
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICAL PATHOLOGY CONSULTANTS, PA
Provider Business Mailing Address
First Line : PO BOX 1599
Second Line :
City : CONWAY
State : SC
Zip : 29528-1599
Country : US
Telephone Number : 843-347-7144
Fax Number : 843-347-7331
Provider Business Practice Location Address
First Line : 300 SINGLETON RIDGE RD
Second Line :
City : CONWAY
State : SC
Zip : 29526-9142
Country : US
Telephone Number : 843-347-7144
Fax Number : 843-347-7331
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID M WILSON
Credential : M.D.
Telephone Number : 843-347-7144
Provider Enumeration Date : 05/15/2006
Last Update Date : 06/05/2026

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