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Organization
PATHOLOGY ASSOCIATES OF LEXINGTON PA
Active
Organization
PATHOLOGY ASSOCIATES OF LEXINGTON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERVIN BAXTER SHAW M.D. (PRESIDENT)
(803) 791-2410
Entity
Organization
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-8146
(803) 936-8916
Mailing address
PO BOX 2375, WEST COLUMBIA, SC 29171-2375
(803) 936-8146
(803) 936-8916
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
19801
SC
207ZH0000X
Hematology (Pathology) Physician
8992
SC
207ZN0500X
Neuropathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
6123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA5173
—
SC
Enumeration date
04/04/2006
Last updated
03/03/2016
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