Individual
LI MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
060276
GA
207ZC0006X
Clinical Pathology Physician
60276
GA
207ZC0500X
Cytopathology Physician
060276
GA
207ZD0900X
Dermatopathology (Pathology) Physician
060276
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0431544
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
060276
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
103627
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD.023759
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD433014
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630468641
—
GA
05
—
630468641A
—
GA
05
—
630468641B
—
GA
05
—
630468641C
—
GA
05
—
630468641D
—
GA
05
—
630468641E
—
GA
05
—
630468641F
—
GA
05
—
630468641G
—
GA
05
—
630468641H
—
GA
05
—
630468641I
—
GA
05
—
630468641J
—
GA
Enumeration date
06/02/2008
Last updated
12/10/2010
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