Organization
CRAVEN PATHOLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH WILKINSON BENNERT MD (PRESIDENT)
(252) 633-8069
Entity
Organization
Contact information
Practice address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 637-9298
(252) 633-8941
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 664-4300
(843) 664-4308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
36652
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36652
NC
207ZP0104X
Chemical Pathology Physician
30691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01078
BCBS
NC
05
—
7901078
—
NC
Enumeration date
02/27/2006
Last updated
01/15/2008
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