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Organization
THREE RIVERS PATHOLOGY PA
Active
Organization
THREE RIVERS PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARS T CONWAY MD (PRESIDENT)
(651) 635-9700
Entity
Organization
Contact information
Practice address
2664 PATTON ROAD, ROSEVILLE, MN 55113
(651) 635-9700
(651) 635-9026
Mailing address
PO BOX 1450, N W 5737, MINNEAPOLIS, MN 55485-5737
(651) 635-9700
(651) 635-9026
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13984TH
BCBS
MN
01
—
C03199
RR MEDICARE
MN
Enumeration date
04/06/2006
Last updated
09/11/2025
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