Organization
BOLIVAR PATHOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA G SPARACINO MD (PATHOLOGIST)
(601) 573-2307
Entity
Organization
Contact information
Practice address
901 E SUNFLOWER RD, 901 HWY 8 EAST, CLEVELAND, MS 38732-2833
(662) 846-5689
(662) 846-2244
Mailing address
PO BOX 98535, RALEIGH, NC 27624-8535
(919) 420-7811
(919) 420-7815
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
16044
MS
291U00000X
Clinical Medical Laboratory
16044
MS
Other
Enumeration date
11/09/2006
Last updated
02/04/2011
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