Organization
RENAISSANCE PATHOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK SAUNDERS JORDAN M.D. (PRESIDENT)
(336) 623-9711
Entity
Organization
Contact information
Practice address
117 E KINGS HWY, EDEN, NC 27288-5201
(336) 623-9711
(336) 627-0900
Mailing address
PO BOX 767, EDEN, NC 27289-0767
(336) 623-9711
(336) 627-0900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
115326
NC
Other
Enumeration date
09/14/2006
Last updated
09/13/2010
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