Organization
CARLSON PATHOLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE A CARLSON MD (PRESIDENT)
(508) 941-7414
Entity
Organization
Contact information
Practice address
680 CENTRE ST, PATHOLOGY DEPARTMENT, BROCKTON, MA 02302-3308
(508) 941-7414
(508) 941-6295
Mailing address
680 CENTRE ST, PATHOLOGY DEPARTMENT, BROCKTON, MA 02302-3308
(508) 941-7414
(508) 941-6295
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9769978
—
MA
Enumeration date
07/05/2006
Last updated
08/22/2020
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