Organization
MOUNTAIN PATHOLOGY SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LAWRENCE SELBY MD (PRESIDENT)
(828) 586-7114
Entity
Organization
Contact information
Practice address
68 HOSPITAL RD, SYLVA, NC 28779-2722
(828) 586-7114
Mailing address
PO BOX 409, BLUEFIELD, WV 24701-0409
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02659
BCBS OF NC
NC
05
—
7902659
—
NC
01
—
CE1406
RAILROAD MEDICARE
—
Enumeration date
05/10/2006
Last updated
06/12/2013
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