Organization
PATHOLOGY ASSOCIATES OF SOUTHWESTERN VIRGINIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LYNN CARLO-DEMOVICH MD (PRESIDENT/OWNER)
(276) 236-1690
Entity
Organization
Contact information
Practice address
200 HOSPITAL DR, GALAX, VA 24333-2227
(276) 236-1690
Mailing address
PO BOX 6446, CHRISTIANSBURG, VA 24068-6446
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5922192
—
NC
01
—
CA9002
RAILROAD MEDICARE
VA
Enumeration date
05/27/2005
Last updated
05/01/2013
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