| NPI | 1790634822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANDA MCPHERSON Sr. Provider Enrollment Specialist 301-315-3102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2026-01-22 |
| Last Update Date | 2026-02-09 |