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Organization
PENINSULA PATHOLOGY ASSOCIATES, PA
Active
Organization
PENINSULA PATHOLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY L BENNING MD (PRESIDENT)
(410) 546-6400
Entity
Organization
Contact information
Practice address
100 EAST CARROLL STREET, SALISBURY, MD 21801-5493
(410) 546-6400
Mailing address
100 EAST CARROLL STREET, SALISBURY, MD 21801-5493
(410) 546-6400
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9177
RAILROAD MEDICARE
MD
01
—
R807
GHI
DC
01
—
S445
BLUE SHIELD
MD
Enumeration date
10/03/2006
Last updated
10/23/2007
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