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Organization
GWINNETT PATHOLOGY ASSOC PC
Active
Organization
GWINNETT PATHOLOGY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO J DELGADO MD (PRESIDENT)
(678) 312-4524
Entity
Organization
Contact information
Practice address
1000 MEDICAL CENTER BLVD, PATHOLOGY DEPT, LAWRENCEVILLE, GA 30046-7694
(678) 312-4524
(770) 682-2219
Mailing address
PO BOX 1686, INDIANAPOLIS, IN 46206-1686
(706) 232-0156
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030501
—
GA
Enumeration date
03/29/2006
Last updated
06/08/2017
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