MEDICARE: DR. PAUL SAMUEL MEADE M.D.

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	150240	NY

General Provider Information

NPI Number	:	1356344279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SAMUEL MEADE M.D.

Provider Business Mailing Address
First Line	:	MOUNT ST. MARY'S HOSPITAL LABORATORY
Second Line	:	5300 MILITARY RD
City	:	LEWISTON
State	:	NY
Zip	:	14092-2061
Country	:	US
Telephone Number	:	716-298-2216
Fax Number	:	716-298-2097

Provider Business Practice Location Address
First Line	:	MOUNT ST. MARY'S HOSPITAL LABORATORY
Second Line	:	5300 MILITARY RD
City	:	LEWISTON
State	:	NY
Zip	:	14092-2061
Country	:	US
Telephone Number	:	716-298-2216
Fax Number	:	716-298-2097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/12/2007

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