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Organization

PATHOLOGY & FORENSIC CONSULTANTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PRAMOD K CARPENTER MD (PRESIDENT)
(260) 969-1950
Entity
Organization

Contact information

Practice address
700 BROADWAY, FORT WAYNE, IN 46802
(260) 425-3762
(260) 425-3298
Mailing address
PO BOX 10480, FORT WAYNE, IN 46852
(260) 969-1950
(260) 918-2137

Taxonomy

Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000487821
BCBS
IN
05
200825690A
IN
05
2673790
OH
05
2673807
OH
05
2673816
OH
01
DF4174
RAILROAD MEDICARE
IN
Enumeration date
07/04/2006
Last updated
07/21/2010
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