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Organization
FAYETTEVILLE ASSOCIATES IN LABORATORY MEDICINE
Active
Organization
FAYETTEVILLE ASSOCIATES IN LABORATORY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERALD F WOLFORD MD (PRESIDENT)
(703) 257-1440
Entity
Organization
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304
(910) 615-4000
(703) 257-1440
Mailing address
9834 BUSINESS WAY, MANASSAS, VA 20110
(703) 257-1440
(703) 257-4337
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901571
—
NC
Enumeration date
05/03/2006
Last updated
05/20/2014
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