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Organization
PATHOLOGY & FORENSIC CONSULTANTS LLC
Active
Organization
PATHOLOGY & FORENSIC CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAMOD K CARPENTER MD (PRESIDENT)
(260) 969-1950
Entity
Organization
Contact information
Practice address
700 BROADWAY, FORT WAYNE, IN 46802
(260) 425-3762
(260) 425-3298
Mailing address
PO BOX 10480, FORT WAYNE, IN 46852
(260) 969-1950
(260) 918-2137
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000487821
BCBS
IN
05
—
200825690A
—
IN
05
—
2673790
—
OH
05
—
2673807
—
OH
05
—
2673816
—
OH
01
—
DF4174
RAILROAD MEDICARE
IN
Enumeration date
07/04/2006
Last updated
07/21/2010
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