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NPI Code Detail

MEDICARE: CAROLINA PATHOLOGY ASSOCIATES LLP

MEDICARE: CAROLINA PATHOLOGY ASSOCIATES LLP
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
1207ZP0101XAnatomic Pathology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CD1791OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2736121OTHERCHAMPUS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518944107
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA PATHOLOGY ASSOCIATES LLP
Provider Business Mailing Address
First Line : PO BOX 602399
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-2399
Country : US
Telephone Number : 804-350-2889
Fax Number : 804-545-0652
Provider Business Practice Location Address
First Line : 1325 SPRING ST
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-3860
Country : US
Telephone Number : 864-725-4822
Fax Number : 864-725-4679
Authorized Official
Title or Position : PARTNER
Name : DR. DARRYL LYNN MCLEOD
Credential : MD FACP FACPE
Telephone Number : 864-725-4822
Provider Enumeration Date : 12/27/2005
Last Update Date : 01/04/2012

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Directions to “CAROLINA PATHOLOGY ASSOCIATES LLP ” Practice Location

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