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Organization
PETERSBURG PATHOLOGY ASSOCIATES LTD.
Active
Organization
PETERSBURG PATHOLOGY ASSOCIATES LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD T SIEGMUND MD (PATHOLOGIST)
(804) 862-5010
Entity
Organization
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5026
(804) 862-5582
Mailing address
PO BOX 8909, JACKSONVILLE, FL 32239-0909
(804) 765-5026
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055573
BCBS
VA
Enumeration date
10/31/2006
Last updated
04/27/2009
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