Organization
PATHOLOGY AND LABORATORY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WELLS MD (CHIEF PATHOLOGIST)
(770) 458-6103
Entity
Organization
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(770) 458-6103
(770) 234-0437
Mailing address
3300 BUCKEYE RD, SUITE 178, ATLANTA, GA 30341-4229
(770) 458-6103
(770) 234-0437
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB5863
RAILROAD MEDICARE
GA
Enumeration date
04/12/2007
Last updated
04/03/2008
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