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Organization
CHARLESTON PATHOLOGY PA
Active
Organization
CHARLESTON PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE FREDERICK WORSHAM JR. MD (PRESIDENT)
(843) 724-2068
Entity
Organization
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 724-2068
(843) 727-3631
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
SC
207ZD0900X
Dermatopathology (Pathology) Physician
—
SC
207ZH0000X
Hematology (Pathology) Physician
—
SC
207ZP0101X
Anatomic Pathology Physician
—
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2141
—
SC
Enumeration date
06/06/2008
Last updated
06/06/2008
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