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Organization
KANAWHA PATHOLOGY ASSOCIATES INC
Active
Organization
KANAWHA PATHOLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M FULKS MD (PRESIDENT/PATHOLOGIST)
(304) 766-3560
Entity
Organization
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3560
Mailing address
PO BOX 9129, SOUTH CHARLESTON, WV 25309-0129
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
07/20/2005
Last updated
10/11/2007
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