Organization
PATHOLOGY ASSOCIATES OF LEXINGTON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERVIN BAXTER SHAW M.D. (PRESIDENT)
(803) 791-2410
Entity
Organization
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-8146
(803) 936-8916
Mailing address
PO BOX 2375, WEST COLUMBIA, SC 29171-2375
(803) 936-8146
(803) 936-8916
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
19801
SC
207ZH0000X
Hematology (Pathology) Physician
8992
SC
207ZN0500X
Neuropathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
6123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA5173
—
SC
Enumeration date
04/04/2006
Last updated
03/03/2016
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