Organization
WEIRTON PATHOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA A BRANCAZIO MD (OWNER)
(304) 797-6332
Entity
Organization
Contact information
Practice address
601 COLLIERS WAY, LAB, WEIRTON, WV 26062-5014
(304) 797-6332
Mailing address
PO BOX 2288, WEIRTON, WV 26062-1488
(304) 797-6332
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
20178
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2316701
—
OH
05
—
4005067000
—
WV
Enumeration date
06/30/2006
Last updated
08/22/2020
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