Organization
PEDIATRIC PATHOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL M COFFIN MD (DIVISION HEAD-PEDIATRIC PATHOLOGY)
(801) 588-3165
Entity
Organization
Contact information
Practice address
100 N MEDICAL DR, PATHOLOGY, SALT LAKE CITY, UT 84113-1103
(801) 588-3165
(801) 588-3169
Mailing address
100 N MEDICAL DR, PEDIATRIC PATHOLOGY, SALT LAKE CITY, UT 84113-1103
(801) 588-3165
(801) 588-3169
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZF0201X
Forensic Pathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
207ZP0104X
Chemical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
207ZP0213X
Pediatric Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502354
—
NV
05
—
118430000
—
WY
05
—
807250500
—
ID
Enumeration date
09/21/2006
Last updated
09/07/2011
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