Organization
RALEIGH PATHOLOGY RESOURCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUKJUNG GERALD KOH MD (MEDICAL DIRECTOR)
(304) 256-4157
Entity
Organization
Contact information
Practice address
1710 HARPER RD, BECKLEY, WV 25801-3357
(304) 256-4157
Mailing address
39 FOX SPARROW RD, BECKLEY, WV 25801-3687
(304) 256-4157
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204127000
—
WV
Enumeration date
08/29/2007
Last updated
09/19/2007
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