Organization
NORTH STAR PATHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGH E FRASER III MD (PRESIDENT)
(336) 951-4551
Entity
Organization
Contact information
Practice address
618 S MAIN ST, REIDSVILLE, NC 27320-5020
(336) 951-4551
(336) 951-4909
Mailing address
PO BOX 3391, MARTINSVILLE, VA 24115-3391
(276) 670-2400
(276) 670-2406
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0178X
BCBS OF NC
NC
05
—
5900080
—
NC
05
—
89011VC
—
NC
01
—
CJ7179
RAILROAD MEDICARE
—
Enumeration date
08/18/2005
Last updated
08/22/2020
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