Organization
MERCED PATHOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT P CARMICHAEL IV M.D. (PRESIDENT)
(209) 723-4551
Entity
Organization
Contact information
Practice address
3329 G ST, MERCED, CA 95340-0964
(209) 723-4551
(209) 723-0141
Mailing address
3329 G ST, MERCED, CA 95340-0964
(209) 723-4551
(209) 723-0141
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF1095
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB44024F
—
CA
Enumeration date
08/19/2005
Last updated
07/13/2011
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