Organization
DAVID RESEN PATHOLOGY SERVICES S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIBETH RESEN (VICE PRESIDENT)
(920) 376-1255
Entity
Organization
Contact information
Practice address
8619 EDGEWATER RDG, OMRO, WI 54963-9760
(920) 376-1255
Mailing address
8619 EDGEWATER RDG, OMRO, WI 54963-9760
(920) 376-1255
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
32951
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33321900
—
WI
Enumeration date
11/18/2009
Last updated
10/28/2015
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