Organization
SKIN PATHOLOGY LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAG BHAWAN M.D. (PRESIDENT)
(617) 638-5570
Entity
Organization
Contact information
Practice address
609 ALBANY ST FL 3, BOSTON, MA 02118-2515
(617) 638-5570
(617) 638-5575
Mailing address
680 WORCESTER RD, FRAMINGHAM, MA 01702-5259
(508) 620-2800
(508) 620-2808
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9750878
—
MA
Enumeration date
02/22/2007
Last updated
08/22/2020
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