Organization
DERMATOPATH LAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE C. HINES M.D. (MEDICAL DIRECTOR)
(508) 226-5540
Entity
Organization
Contact information
Practice address
555 PLEASANT ST, SUITE 106, ATTLEBORO, MA 02703-2400
(508) 226-5540
(508) 226-9619
Mailing address
555 PLEASANT ST, SUITE 106, ATTLEBORO, MA 02703-2400
(508) 226-5540
(508) 226-9619
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
2413
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013986
NHP
MA
05
—
0805548
—
MA
01
—
1171
NHP
RI
01
—
1847-0
BCBS
RI
01
—
228418
BCBS
MA
01
—
350062
UHC
MA
01
—
4754 MIR
HARVARD/PILGRIM
MA
01
—
607206
TUFTS
MA
05
—
9418065
—
RI
01
—
C028629
CHAMPUS
MA
Enumeration date
05/26/2006
Last updated
12/05/2007
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