Individual
MARIO T. ANSELMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MACCORKLE AVENUE SE, PATHOLOGY DEPARTMENT, CHARLESTON, WV 25304
(304) 388-5550
(304) 388-4352
Mailing address
DEPT OF PATHOLOGY, 3200 MACCORKLE AVE SE, CHARLESTON, WV 25304
(304) 388-5550
(304) 388-4352
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16616
WV
Other
Enumeration date
05/17/2006
Last updated
11/23/2015
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