Organization
KMC PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAMESH C MAHAPATRO MD (PRESIDENT)
(732) 557-8526
Entity
Organization
Contact information
Practice address
600 RIVER AVE, LAKEWOOD, NJ 08701-5237
(732) 363-1900
Mailing address
PO BOX 60100, CHARLESTON, SC 29419-0100
(800) 503-6254
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0895102000
AMERIHEALTH
—
01
—
1K3134
HEALTHNET
—
01
—
2037958
AETNA
—
05
—
6804802
—
NJ
Enumeration date
05/27/2006
Last updated
04/20/2008
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