Organization
NORTHSHORE PATHOLOGY SERVICES APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECA CANDAL MD (PRESIDENT)
(985) 646-5060
Entity
Organization
Contact information
Practice address
100 MEDICAL CENTER DR, SLIDELL, LA 70461-5520
(985) 646-5060
Mailing address
230 W HALL AVE, PMB 400, SLIDELL, LA 70460-2635
(985) 785-2221
(985) 785-1118
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1943533
—
LA
Enumeration date
08/18/2005
Last updated
08/22/2020
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