Organization
NORTHERN UTAH PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW M KERSHISNIK MD (PRESIDENT)
(435) 716-5375
Entity
Organization
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-5375
(843) 284-3401
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
UT
Other
Enumeration date
02/03/2006
Last updated
01/07/2008
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