Organization
EASTERN PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON E VELAZQUEZ DO (SOLE OWNER)
(304) 252-2673
Entity
Organization
Contact information
Practice address
94 BROOKSHIRE LN, BECKLEY, WV 25801-6765
(304) 252-2673
(304) 929-2350
Mailing address
148 LINDEN DR, SUITE 101, WINCHESTER, VA 22601-6909
(540) 504-0066
(540) 678-9025
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910001297
—
WV
Enumeration date
07/27/2012
Last updated
05/08/2017
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