Organization
ORANGEBURG PATHOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ALEXANDER FANT M.D. (PRESIDENT)
(803) 533-2418
Entity
Organization
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 533-2418
(803) 533-4638
Mailing address
PO BOX 52990, GREENWOOD, SC 29649-0048
(864) 223-3600
(864) 223-6054
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
17118
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3311
—
SC
Enumeration date
04/12/2006
Last updated
04/17/2008
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