Organization
FORTUNATO R MACATOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FORTUNATO R MACATOL (OWNER)
(740) 374-1499
Entity
Organization
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 373-3931
(740) 373-3404
Mailing address
PO BOX 23, MARIETTA, OH 45750-0023
(740) 373-3931
(740) 373-3404
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307840
—
OH
Enumeration date
11/29/2007
Last updated
02/29/2012
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