Organization
PATHOLOGY SERVICES OF SOUTHWEST VIRGINIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL LANGEBECK MD (PRESIDENT)
(540) 953-5465
Entity
Organization
Contact information
Practice address
3700 S MAIN ST, BLACKSBURG, VA 24060-7017
(540) 953-5465
(540) 953-5274
Mailing address
PO BOX 10776, BLACKSBURG, VA 24062-0776
(540) 767-2700
(540) 767-2708
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115189
SOUTHERN HEALTH
—
05
—
4000381000
—
WV
01
—
CG3681
RAILROAD MEDICARE
—
Enumeration date
09/06/2005
Last updated
08/22/2020
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