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NPI Code Detail

MEDICARE: SUMMIT PATHOLOGY ASSOCIATES INC

MEDICARE: SUMMIT PATHOLOGY ASSOCIATES 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1264371OTHERUNITED MINE WORKERS OF AMERICA
28463565OTHERAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
51100545OTHERUNITED HEALTH CARE
6127732600OTHEROHDEPT OF LABOR
7026437100OTHEROHBLACK LUNG
859446OTHEROHQUALCHOICE

General Provider Information

NPI Number : 1508827627
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT PATHOLOGY ASSOCIATES INC
Provider Business Mailing Address
First Line : 30701 LORAIN RD STE A
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-6325
Country : US
Telephone Number : 440-274-5000
Fax Number : 440-716-8608
Provider Business Practice Location Address
First Line : 195 WADSWORTH RD
Second Line :
City : WADSWORTH
State : OH
Zip : 44281-9504
Country : US
Telephone Number : 330-375-3786
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. WILLIAM A HENTHORNE
Credential : MD
Telephone Number : 330-375-3786
Provider Enumeration Date : 03/29/2006
Last Update Date : 06/04/2014

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Directions to “SUMMIT PATHOLOGY ASSOCIATES INC ” Practice Location

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