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Organization

PATHOLOGISTS DIAGNOSTIC LABORATORY PA

Active
Other names
Atlantic Pathology Services PA
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CULLEN A TAYLOR (PRESIDENT)
(336) 999-8888
Entity
Organization

Contact information

Practice address
1800 S HAWTHORNE RD STE 100, WINSTON SALEM, NC 27103-4014
(336) 999-8888
(336) 999-8889
Mailing address
PO BOX 896315, CHARLOTTE, NC 28289-0369
(336) 999-8888
(369) 999-8889

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22288
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010345456
VA
01
014HE
BCBS
NC
05
7001277
NC
Enumeration date
03/01/2006
Last updated
12/12/2025
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