Organization
PATHOLOGY DIAGNOSTIC SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE HENRY HOLSTEN III M.D. (CEO)
(401) 254-1006
Entity
Organization
Contact information
Practice address
377 WOODLAND CIRCLE, LUDLOW, MA 01056
(401) 254-6160
(401) 254-6163
Mailing address
377 WOODLAND CIRCLE, LUDLOW, MA 01056
(401) 254-6160
(401) 254-6163
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
32284
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
32284
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
32284
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9760784
—
MA
Enumeration date
09/14/2006
Last updated
03/23/2016
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